静脉注射葡萄糖联合呋塞米治疗心力衰竭

Intravenous glucose combined with furosemide in the treatment of heart failure

目的 探讨静脉注射50％葡萄糖注射液联合呋塞米治疗心力衰竭的临床疗效.方法 选择顽固性心力衰竭患者71例,根据随机数字表法将患者分为观察组（35例）和对照组（36例）,在常规治疗的基础上,观察组持续静脉泵入呋塞米100 mg,联合静脉注射50％葡萄糖注射液100 mL;对照组间断注射呋塞米300 mg,每天3次,每次100 mg.比较两组治疗效果,比较两组治疗前及治疗后72 h心功能改善情况、24 h尿量、脑钠肽（BNP）及超声心动图指标[左心室舒张末内径（LVEDD）、射血分数（EF）].结果 观察组总有效率为82.86％,显著高于对照组的61.11％,差异有统计学意义（x2=4.15,P＜0.05）.治疗后,两组患者心功能分级、24 h尿量、BNP、EF及LVEDD指标均显著改善,且观察组较对照组改善更加显著,差异均有统计学意义（t =3.23、2.98、3.87、3.12、3.67,均P＜0.05）.观察组不良反应发生率为8.57％,对照组不良反应发生率为13.9％,两组不良反应发生率差异无统计学意义（x2=0.97,P＞0.05）.结论 静脉注射50％葡萄糖注射液联合呋塞米治疗心力衰竭疗效可靠,心功能恢复好,应用价值高.

Objective To explore the clinical effect of intravenous injection of 50% glucose combined with furosemide in the treatment of heart failure.Methods 71 patients with intractable heart failure were selected.According to the random number table,they were divided into the observation group （35 cases） and control group （36 cases）.On the basis of conventional treatment,the observation group received continuous intravenous infusion of furosemide 100mg combined with intravenous injection of 50% glucose 100ml.The control group was given intermittent injection of furosemide 300mg,3 times/day,100mg/each time.Treatment effects were compared between the two groups.The cardiac function,24h urine volume,BNP and ultrasound beckoning figure index including left ventricular end-diastolic diameter （LVEDD）,ejection fraction （EF） before and after 72h treatment of the two groups were compared.Results The total effective rate of the observation group was 82.86%,which was significantly higher than 61.11% of the control group （x2 =4.15,P 〈 0.05）.After treatment,cardiac functional grading,24 hour urine volume,BNP,EF and LVEDD of two groups were significantly improved,and compared with the control group,the improvement of the observation group was more significant,the differences were statistically significant （t =3.23,2.98,3.87,3.12,3.67,P 〈 0.05）.The incidence rate of adverse reaction of observation group was 8.57%,that in control group was 13.9%,there was no statistically significant difference between two groups （x2 =0.97,P 〉 0.05）.Conclusion Effect of furosemide combined with intravenous injection of 50% glucose in the treatment of congestive heart failure is reliable,the cardiac function recovered well,and has high application value.