应用脑钠素检测评价托拉塞米注射液在老年重度心力衰竭患者急性期的疗效

Application of Brain Natriuretic Peptide Evaluation Torasemide Injection Efficacy in Elderly Patients with Severe Heart Failure in Patients withAcute

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。

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）,P0.001）;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.