长期间歇性小剂量利尿剂治疗慢性心衰的可行性研究

目的:评价长期间歇小剂量利尿剂与长期持续小剂量利尿剂对慢性心衰的疗效对比。方法:将280例慢性心衰出院患者随机分为两组各140例,在常规治疗基础上,治疗组:间歇性予螺内酯20mg,2次/日加氢氯噻嗪25mg,2次/日,或加速尿片20mg,1次/日,采用长期口服3天,停2～3天;对照组:予螺内酯20mg2次/日加氢氯噻嗪25mg,2次/日,或加速尿片20mg,1次/日,长期不间断服用。观察患者电解质紊乱发生率及各种原因再入院率。结果:两组患者电解质紊乱发生率有统计学差异(P<0.05),治疗组再入院率低于对照组(P<0.05),有显著差异。结论:间歇性小剂量利尿剂治疗慢性心衰疗效确切,长期服用安全可靠。

Objective：To compare the long - term effect of minidose diuretic agent administered uninterruptedly and periodically on chronic congestive heart failure. Methods： 280 cases of discharged chronic congestive heart failure were divided into 2 groups （ i. e. the control group and the treated group）at random,with 140 cases in each group respectively. At the base of conventional therapy, the patients of the treated group were administered periodically with spironolactone （ 20mg, tid ） combined with hydrochlorothiazide （ 25mg, bid ） or furosemide （ 20mg, qd ）, i. e. administered the above mentioned drug for 3 days continuously, after 3 days without these drug, then, administered these drug for 3 days once again. The patients of the control group were administered with above - mentioned diuretic agent uninterruptedly. In the 2 years of clinical follow - up, the incidence of electrolyte disturbance and the readmission because of the recurrence of con-gestive heart failure was assessed. Results： There was significant difference between the treated group and the control group in the incidence of electrolyte disturbance （ P 〈 0. 05）, there was less incidence of readmission because of the recurrence of congestive heart failure in the treated group than that in the control group（ P 〈 0.05 ）. Conclusion ： There was precise curative effect of minidose diuretic agent administered periodically on chronic congestive heart failure, with security and safty.