呋塞米与托拉塞米对慢性心力衰竭治疗效果的比较

Comparison of furosemide and torasemide in the therapeutic effect on chronic heart failure

目的对比分析呋塞米和托拉塞米对慢性心力衰竭患者电解质、尿量及心功能的影响。方法将194例中、重度慢性心力衰竭患者分为治疗组和对照组,均予常规抗心力衰竭治疗(ACEI、ARB、β受体阻滞剂、地高辛),治疗组予托拉塞米10mg静推、对照组予呋塞米40mg静推,均1次/日,连续7天;比较两组患者治疗前后尿量、电解质及心功能分级改善情况。结果治疗后24h两组尿量变化无统计学差异,血钾均降低,而对照组血钾明显低于治疗组,血钠差异无统计学意义;治疗7天后治疗组心功能分级改善明显好于对照组,差异有统计学意义(P<0.05)。结论托拉塞米与呋塞米的利尿、排钠作用相近,呋塞米排钾作用明显强于托拉塞米,托拉塞米对心功能的改善优于呋塞米。

Objective To compare the electrolytes,urine output and heart function in the chronic heart failure patients with furosemide and torasemide.Methods One hundred and ninety four cases with severe chronic heart failure were randomly divided into torasemide group（treatment group）and furosemide（control group）.Conventional heart failure therapy（ACEI,ARB,beta blockers,digoxin）was used continuously for seven days.24h urine volume,electrolyte and cardiac function were compared before and after treatment in the two groups.Results 24 hours urine output of the treatment groups was no statistically significant（P〈0.05）;potassium decreased after treatment,but potassium in the furosemide group was significantly lower than that in the torasemide group;There no statistically significant in the differences of serum creatinine.After 7 days of treatment,cardiac functional classification improving in the torasemide group was significantly higher than in the furosemide group,the difference was statistically significant（P〈0.05）.Conclusion The function of natriuresis and diuresis with torasemide are similar to furosemide,exclusive potassium with furosemide are significantly stronger than torasemide,and torasemide has a better improvement on cardiac function.