CAJ | 학술논문

目的：探讨传统利尿剂联合新型容量驱除剂奈西立肽和托伐普坦治疗难治性心力衰竭(RHF)的疗效。方法选择该院心血管病重症病房 RHF 患者78例，分为联合容量驱除药物组(CVR 组)和传统强化利尿并正性肌力药物治疗组(对照组)，观察其心力衰竭症状控制率及平均住院日数的差异，以及住院期间平均尿量和体质量下降等容量驱除指标的差异。结果治疗组89.7%的患者心衰症状控制并出院，优于对照组(71.8%)，相应的死亡或放弃治疗率在治疗组显著下降，且平均住院日数较对照组显著缩短(P <0.05)；CVR 组的 NT-proBNP 和治疗前后体质量下降均高于对照组，差异有统计学意义(P <0.05)。结论使用联合的容量驱除治疗措施较传统的治疗措施可显著提高 RHF 的容量驱除和心力衰竭症状控制率。
목적：탐토전통이뇨제연합신형용량구제제내서립태화탁벌보탄치료난치성심력쇠갈(RHF)적료효。방법선택해원심혈관병중증병방 RHF 환자78례，분위연합용량구제약물조(CVR 조)화전통강화이뇨병정성기력약물치료조(대조조)，관찰기심력쇠갈증상공제솔급평균주원일수적차이，이급주원기간평균뇨량화체질량하강등용량구제지표적차이。결과치료조89.7%적환자심쇠증상공제병출원，우우대조조(71.8%)，상응적사망혹방기치료솔재치료조현저하강，차평균주원일수교대조조현저축단(P <0.05)；CVR 조적 NT-proBNP 화치료전후체질량하강균고우대조조，차이유통계학의의(P <0.05)。결론사용연합적용량구제치료조시교전통적치료조시가현저제고 RHF 적용량구제화심력쇠갈증상공제솔。
Objective To investigate the effect of diuretics combined with the new class volume-removing drugs nesiritide and tolvaptan on refractory heart failure (RHF).Methods We collected 78 patients with RHF from cardiovascular ICU in our hos-pital,and patients were divided into combined volume-removing drugs treatment group (CVR group)and traditional diuretics com-bined with inotropic treatment group (control group).We observed the differences in the heart failure symptoms control rate and the average hospitalization days between the two groups.The difference in average urine volume and weight loss during hospitaliza-tion was observed.Results The heart failure symptoms were controlled and successful discharge in 89.7% of patients in CVR group,which was better than that in control group(71.8%).The corresponding rates of death or abandonment was decreased sig-nificantly in CVR group,and the average number of hospitalization days in CVR group was significantly shorter than that in control group(P <0.05).Meanwhile,the average daily urine volume and the weight loss decreased significantly in CVR group than those in control group(P <0.05).Conclusion The therapy strategy of combined volume-removing drugs can significantly improve the vol-ume removing and control rate of heart failure symptoms.