强心剂及利尿剂治疗心源性肝淤血121例对照研究

Observe and Compare the Therapeutic Effects of Using Cardiac and Diuretic in 121 Patients with Liver Congestion of Congestion Heart Failure

目的观察强心剂及利尿剂对121例心源性肝淤血患者治疗疗效并进行对比性研究。方法自1994年8月～2002年6月,我科收治的121例以心脏收缩功能障碍为主的心源性肝淤血患者随机分为两组:强心剂组(60例)使用以强心剂洋地黄、磷酸二酯酶抑制剂、拟多巴胺类为主的治疗方案,利尿剂组(61例)使用以利尿剂呋塞米、双氢克脲塞、安体舒通为主的治疗方案,观察肝脏大小、边缘、质地及肝功能恢复情况,并对疗效进行对比性研究。结果121例患者中,利尿剂组中56例有效,4例无效,1例死亡。强心剂组中46例有效,12例无效,2例死亡。利尿剂治疗心源性肝淤血明显优于强心剂,二者对比差异有显著性意义(P<0.05)。结论利尿剂治疗心源性肝淤血优于强心剂,可能是与右心衰时以容量负荷加重、右心室心肌较左心室少有关。其机制有待于进一步探讨。

Objective To observe and compare the therapeutic effects of using cardiac and diuretic in 121 patients with liver congestion of congestive heart failure. Methods 121 patients with liver congestion of congestive heart failure were selected from outpatients of our hospital between August 1994 and June 2002. The patients mainly occurred heart systolic dysfunction. According to random principle, patients were divided into two groups： one group using cardiac digitalis, PDEI, dopamine analogues and the other using diuretic furosemide hydrochloro chiazide, spironolactone. Then we observed liver size, edge, quality and liver function and compare the therapeutic effects. Results Among 61 patients using diuretic, 56 valid, 4 invalid, 1 dead. Among 60 patients using cardiac, 46 validl2 invalid, 2 dead. There was obviously significance in two groups （ P 〈 0. 05）. Conclusion This study showed diuretic was more effective than cardiac in treatment patients with live congestion of congestive heart failure.