托拉塞米与呋塞米治疗儿童肾病综合征伴高度水肿的疗效评价

Torasemide and Furosemide in the Treatment of Children Nephrotic Syndrome with Height Edema

目的:观察托拉塞米与呋塞米治疗儿童肾病综合征引起水肿的临床疗效。方法:选取54例儿童肾病综合征患儿,将54例患儿分为托拉塞米组、呋塞米加口服补钾组、呋塞米组各18例。三组患儿在激素及一般治疗的基础上,托拉塞米组给予静脉注射托拉塞米1 mg/(kg·d),每次不超过20 mg;呋塞米加口服补钾组给予静脉注射呋塞米2 mg/(kg·d),每次不超过40 mg,并口服补钾;呋塞米组给予静脉注射呋塞米2 mg/(kg·d),每次不超过40 mg。三组患儿分别于治疗前1 d、治疗后每天记录24 h尿量,治疗前及治疗后第4天抽外周血查电解质的变化情况,并记录不良反应。结果:三组患儿治疗后尿量较治疗前均显著增多,但治疗后前3 d平均尿量三组比较差异无统计学意义(P>0.05);呋塞米组治疗后第4天血钾浓度较其余两组降低明显(P<0.05);托拉塞米组和呋塞米加口服补钾组患儿治疗后第4天血钾浓度比较差异无统计学意义(P>0.05)。结论:临床上对于儿童肾病综合征引起的水肿应用托拉塞米或呋塞米治疗效果显著。应用呋塞米时同时口服补钾可减轻其致低血钾的不良反应。

Objective： To evaluate the efficacy of the torasemide and furosemide in the treatment of nephrotic syndrome with height edema. Methods： Fifty-four cases of children nephmtic syndrome were divided into torasemide group （ 18 cases）, furosemide plus oral potassium group （18 cases）, furosemide group （18 eases）. On the basis of glucocorticoids and general treatment, torasemide group was performed intravenous infusion of torasemide 1 rag/（ kg · d）, no more than 20 rag, furosemide plus oral potassium group was performed intravenous infusion of furosemide 2 mg/（ kg· d）, no more than 40 mg, and daily oral potassium, furosemide group was performed intravenous infusion of furosemide 2 mg/（kg · d） , no more than 40 rag. The 24 h urine, electrolyte changes, and the adverse reactions the day before treatment and after treatment of three groups were detected and analyzed. Results： The urine output in the three groups increased significantly compared with before treatment. The first 3 days after each treatment group, on average, there was no statistically significant difference of urine volume （P 〉 O. 05 ）. The forth days after treatment, potassium concentration in furosemide group was significantly lower compared with the other two groups （P〈0.05）, potassium concentration in torasemide group and furosemide plus oral potassium supplement group had no statistical significance （ P〉O. 05 ）. Conclusion： The effects of torasemide or furosemide in treatment of edema caused by children nephrotic syndrome are remarkable. Furosemide can cause hypokalemia, main side effects with furosemide and oral potassium supplement can alleviate the adverse reaction of hypokalemia.