呋塞米与托拉塞米治疗老年慢性心力衰竭伴利尿剂抵抗短期治疗观察

Furosemide and Torasemide Treatment of Elderly Patients with Chronic Heart Failure with Diuretics to Resist Short-term Treatment Observation

目的:观察老年慢性心力衰竭(CHF)伴利尿剂抵抗患者短期应用呋塞米、托拉塞米对利尿剂抵抗的临床疗效。方法:随机将老年CHF伴利尿剂抵抗患者分为呋塞米泵入组(A组)32例和托拉塞米组(B组)32例,治疗5d,比较两组疗效,治疗前后血BNP、血电解质变化,尿量、肾功能变化。结果:B组改善心力衰竭总有效率高于A组(P<0.05);两组治疗前后血BNP变化无统计学意义(P>0.05);A组血钾治疗前后出现降低(P<0.05);B组血钾改变不明显(P>0.05);两组治疗前后血钠变化不明显(P>0.05)。两组治疗后患者每日尿量明显增多(P<0.01),B组尿量较A组尿量增加明显(P<0.01)。血肌酐两组治疗前后变化不明显。结论:短期呋塞米泵入和托拉塞米注射法均可以改善老年CHF伴利尿剂抵抗,能够增加尿量,改善心功能,托拉塞米改善心力衰竭总有效率高于呋塞米。

Objective：To observe elderly patients with chronic heart failure（CHF） with diuretic resistance in patients with shortterm application of furosemide,torasemide clinical efficacy of diuretic resistance were observed.Methods：Randomly elderly CHF with a diuretic resistant patients divided into of furosemide pumped into the group（group A）,32 cases of 32 cases and the torasemide group（group B）,5 days of treatment to compare two groups,blood BNP,blood electrolyte changes before and after treatment,urine output and kidney function.Results：Group B improved heart failure there is always more efficient than group A（P〈0.05）;Changes in plasma levels of BNP before and after treatment was statistically significant（P〉0.05）;Treatment in group A serum potassium before and after treatment to reduce a statistically significant difference（P〈0.05）;Group B,serum potassium change is not obvious（P〉0.05）;After treatment,patients with daily urine output increased significantly（P〈0.01）,urine group B than group A urine output increased significantly（P〈0.01）.Serum creatinine before and after treatment did not change significantly.Conclusion：Short-term furosemide pump into the torasemide injection can improve the resistance in elderly CHF with diuretics to increase urine output,and improve heart function,torasemide to improve heart failure there is always more efficient than furosemide.