托拉塞米对慢性心力衰竭心功能Ⅲ～Ⅳ级患者预后的影响

Influence by torasemide on prognosis in chronic heart failure patients with grade Ⅲ～Ⅳ cardiac function

目的观察托拉塞米对慢性心力衰竭(CHF)心功能Ⅲ~Ⅳ级患者预后的影响。方法 93例CHF心功能Ⅲ~Ⅳ级患者,采用隐匿数字随机法分为观察组(47例)和对照组(46例)。入院后均给予相同的基础治疗,观察组患者利尿剂采用托拉塞米,对照组患者采用呋塞米,比较两组患者患者水肿、呼吸困难等症状缓解和消失时间、不良反应、24 h尿量增加量;出院后随访12个月,比较两组患者因心力衰竭加重引起的死亡例数、再次住院频度。结果观察组患者主要症状缓解时间、主要症状消失时间均短于对照组,24 h尿量增加大于对照组,再次住院频度少于对照组,差异均具有统计学意义(P<0.05)。随访12个月,观察组因心力衰竭加重引起的死亡5例,死亡率为10.64%;对照组死亡13例,死亡率为28.26%,比较差异具有统计学意义(P<0.05)。观察组低血钾发生率为6.38%,低于对照组的21.74%,差异具有统计学意义(P<0.05)。结论托拉塞米对CHF心功能Ⅲ~IV级患者预后改善有显著的作用,而且安全性更好。

Objective To observe influence by torasemide on prognosis in chronic heart failure(CHF)patients with gradeⅢ~Ⅳcardiac function.Methods A total of93CHF patients with gradeⅢ~Ⅳcardiacfunction were divided by hidden number random method into observation group(47cases)and control group(46cases).They all received basic therapy after admission.The observation group received torasemide as diuretic,andthe control group received furosemide instead.Comparison was made on symptom relief and disappearance time ofedema and dyspnea,adverse reactions,and24h urine volume increment.Follow-up for12months after dischargewas made to compare death cases with heart failure exacerbation and rehospitalization frequency between the twogroups.Results The observation group had all shorter main symptom relief and disappearance time than thecontrol group,along with higher24h urine volume increment than the control group and lower rehospitalization frequency than the control group.Their difference had statistical significance(P<0.05).After12-month followup,there were5death cases due to heart failure exacerbation,with mortality rate as10.64%.There were13deathcases in the control group,with mortality rate as28.26%.Their difference had statistical significance(P<0.05).The observation group had lower incidence of hypokalemia as6.38%than21.74%in the control group,and thedifference had statistical significance(P<0.05).Conclusion Torasemide shows excellent effect in improvingprognosis in CHF patients with gradeⅢ~Ⅳcardiac function,along with good safety.