托拉塞米在儿童肾病综合征中利尿作用的临床疗效分析

Diuretic effect of torasemil for children with nephrotic syndrome

目的 观察托拉塞米对肾病综合征患儿利尿的影响,并与呋塞米进行对比分析。方法选取2016年1月至2019年1月本院患有肾病综合征和高水肿患儿68例,随机分为托拉塞米组和呋塞米组,各34例。托拉塞米组用静滴托拉塞米1mg/(kg·d),1次/d;呋塞米组用静滴呋塞米1mg/(kg·d),1次/d。两组分别监测治疗前、治疗后第2d、5d、7d的24h尿量、电解质以及肾功能的变化情况,并记录不良反应。结果 治疗后第2d、5d、7d,托拉塞米组24h尿量分别为(958.78±96.83)ml/d、(1283.88±117.35)ml/d、(1368.72±132.35)ml/d,均高于呋塞米组,差异均有统计学意义(均P<0.05);治疗后第2d、5d、7d,托拉塞米组血钾水平分别为(4.37±0.43)mmol/L、(3.98±0.53)mmol/L、(3.63±0.39)mmol/L,均高于呋塞米组,差异均有统计学意义(均P<0.05),而两组血钠水平比较,差异均无统计学意义(均P>0.05);托拉塞米组血肌酐在治疗后第7d、血尿素氮水平在治疗后第5d、7d,均优于呋塞米组,差异均有统计学意义(均P<0.05)。结论 托拉塞米保钾、利尿作用强于呋塞米,且能在一定程度上改善患儿的肾功能水平,在儿童肾病综合征水肿的治疗上,托拉塞米在治疗效果及安全性上均优于呋塞米。

Objective To observe the influences of torasemil versus furasemide on diuretic effect in children with nephrotic syndrome. Methods Sixty-eight children with nephrotic syndrome treated with oral prednisone were randomly divided into a torasemib group and a furosamib group, with 34 cases in each group. The torasemib group were intravenously dripped torasemib, 1 mg/(kg·d), once a day;the furasemide group were intravenous dripped furasemide, 1 mg/(kg·d), once a day. The clinical treatment efficacy and the changes of blood electrolytes, renal functionand, and 24 h urine volume before and after the treatment of the two groups were compared. Results Day 2, 5, and 7 after the treatment, the urine volumes were (958.78±96.83) ml/d,(1 283.88±117.35) ml/d, and (1 368.72±132.35) ml/d in the torasemibe group, which were higher than those in the furosemide group (all P < 0.05). Day 2, 5, and 7 after the treatment, the potassium levels were (4.37±0.43) mmol/L,(3.98±0.53) mmol/L, and (3.63±0.39) mmol/L in the torasemibe group, which were higher than those in the furosemide group (all P < 0.05). There were no statistical differences in the sodium levels between the two groups (all P >0.05). The serum creatinine and blood urea nitrogen levels were better in the torasemibe group than in the furosemide group after the treatment. Conclusion The potassium and diuretic effects of torasemibe are stronger than those of furosemide, and can improve the children乫 renal function to a certain extent. Torasemibe in the treatment of children with nephrotic syndrome edema has better therapeutic effect and safety than furosemide.