CAJ | 학술논문

目的:通过检测老年中重度心力衰竭(HF)急性发作时患者血浆脑钠素(BNP)水平监测利尿剂托拉塞米(Torasemide)对急性HF的疗效.方法:63例老年终末期HF急性发作患者63例,随机分为治疗组(托拉塞米组):托拉塞米20mg/次,每日1次静脉注射,疗程为7d;对照组(呋塞米组):呋塞米20mg/次,每日1次静脉注射,疗程为7d.所有患者入院后即刻床边抽取静脉血测血浆BNP水平并行心脏超声检查,检测用药前后7天的BNP含量、射血分数(EF)、血压和K+浓度.结果:治疗7天后,治疗组BNP水平下降(993.32到268.53),对照组BNP水平下降(635.62到148.11),P<0.001);钾离子水平无明显变化;EF值:治疗组(33.64到37.12)与对照组(37.02到38.32)比较无明显差异(P>0.05);收缩压两组在治疗前后均有明显下降但组间无明显差异(P>0.05).从疗效上看治疗组优于对照组(96.3%vs 88.1%),从低血钾、低血压等不良反应上看,托拉塞米组少于呋塞米组.结论:血浆中BNP水平是评价HF程度的有效指标;托拉塞米在老年中重度HF急性发作期时使用与呋塞米相比是有效的、安全的.
목적:통과검측노년중중도심력쇠갈(HF)급성발작시환자혈장뇌납소(BNP)수평감측이뇨제탁랍새미(Torasemide)대급성HF적료효.방법:63례노년종말기HF급성발작환자63례,수궤분위치료조(탁랍새미조):탁랍새미20mg/차,매일1차정맥주사,료정위7d;대조조(부새미조):부새미20mg/차,매일1차정맥주사,료정위7d.소유환자입원후즉각상변추취정맥혈측혈장BNP수평병행심장초성검사,검측용약전후7천적BNP함량、사혈분수(EF)、혈압화K+농도.결과:치료7천후,치료조BNP수평하강(993.32도268.53),대조조BNP수평하강(635.62도148.11),P<0.001);갑리자수평무명현변화;EF치:치료조(33.64도37.12)여대조조(37.02도38.32)비교무명현차이(P>0.05);수축압량조재치료전후균유명현하강단조간무명현차이(P>0.05).종료효상간치료조우우대조조(96.3%vs 88.1%),종저혈갑、저혈압등불량반응상간,탁랍새미조소우부새미조.결론:혈장중BNP수평시평개HF정도적유효지표;탁랍새미재노년중중도HF급성발작기시사용여부새미상비시유효적、안전적.
@@@@Objective: By detecting the plasma of patients with acute exacerbation of brain natriuretic peptide (BNP) level monitoring diuretic torasemide (Torasemide) the efficacy of acute HF in the elderly severe heart failure (HF).Methods:The end of the old year-end of 63 cases HF acute episodes 63 patients were randomly divided into a treatment group (Torasemide group):torasemide 20mg/d intravenous treatment for 7 days;controls (furosemidegroup):furosemide 20mg/d intravenous treatment for 7d. Blood samples were measured in plasma BNP levels in all patients after admission immediate bedside parallel cardiac ultrasound detected seven days before and after treatment BNP content, ejection fraction (EF), blood pressure and K+concentration. Results:After 7 days of treatment, the treatment group BNP levels (993.32 to 268.53), control group BNP levels decreased (635.62 to 148.11), P<0.001);no significant change in the level of potassium;EF value:the treatment group (33.64 to 37.12) andthe control group (37.02 to 38.32) showed no significant difference (P>0.05);systolic blood pressure two groups before and after treatment were significantly reduced but there was no significant difference between the groups (P>0.05). Point of view from the efficacy of the treatment group than the control group (96.3%vs 88.1%), hypokalemia, hypotension and other adverse reactions point of view, torasemide group less than furosemide group. Conclusion:BNP levels in the plasma is an effective indicator of the extent of the evaluation of HF;Torasemide severe HF in older acute exacerbation of use compared with furosemide is effective and safe.