托拉塞米治疗慢性心力衰竭(CHF)患者的临床疗效及安全性分析

Clinical Efficacy and Safety Analysis of Toracemide in the Treatment of Chronic Heart Failure

目的探讨慢性心力衰竭在常规抗心衰治疗基础上,加用托拉塞米总有效率及对生化指标、心功能指标和安全性的影响情况。方法选择慢性心力衰竭患者80例,均为我院心血管内科2018年1月至2020年1月收治,在采用常规抗心衰方案治疗基础上,随机分组,就加用呋塞米治疗(对照组,n=40)与加用托拉塞米治疗(观察组,n=40)临床总有效率、生化指标、心功能指标、不良反应率展开对比。结果:观察组慢性心力衰竭患者临床总有效率经评定为97.5%,与对照组82.5%比较,差异具有统计学意义(P<0.05)。两组治疗前,生化指标血管紧张素Ⅱ、血浆肾素、B型利尿肽经检测无差异(P>0.05),治疗后各检测值均降低,观察组降低程度更为显著(P<0.05)。治疗前两组左室舒张期内径、左室射血分数、6 min步行试验测定结果无差异(P>0.05),治疗后均有程度不等改善,观察组改善程度更为显著(P<0.05)。观察组肌酐增高、血钾降低、血尿酸各1例,不良反应率为7.5%;对照组肌酐增高2例、血钾降低3例、血尿酸3例、血钠氯降低2例,不良反应率为25%,差异具有统计学意义(P<0.05)。结论针对临慢性心力衰竭患者,在常规抗心衰基础上,加用托拉塞米治疗,可显著提高总有效率,改善生化指标,增强心功能,且具较高安全性,临床指导应用价值十分显著。

Objective To investigate the effect of total effective rate of toracemide on biochemical indexes,cardiac function indexes and safety of chronic heart failure on the basis of conventional anti-heart failure treatment.Methods Choose 80 cases of patients with chronic heart failure,all are our cardiovascular internal medicine in January 2018 to January 2020 were analyzed,based on the conventional heart failure patients with,randomized,add with Sammy therapy(control group,n=40)and add a tora Sammy treatment(observation group,n=40)clinical total effective rate,biochemical index,cardiac function index,rate of adverse reaction in contrast.Results The clinical total effective rate of chronic heart failure patients in the observation group was assessed as 97.5%,compared with 82.5%in the control group,and the difference was statistically significant(P<0.05).Before treatment,the biochemical indexes of angiotensinⅡ,plasma renin and type B diuretic peptide showed no difference between the two groups(P>0.05).After treatment,all the measured values were reduced,and the degree of reduction was more significant in the observation group(P<0.05).Before treatment,there was no difference in left ventricular diastolic diameter,left ventricular ejection fraction,and 6 min walking test between the two groups(P>0.05).After treatment,there was no difference in degree of improvement between the two groups,and the improvement was more significant in the observation group(P<0.05).In the observation group,creatinine was increased,serum potassium was decreased,and serum uric acid was decreased in 1 case,with an adverse reaction rate of 7.5%.In the control group,creatinine increased in 2 cases,serum potassium decreased in 3 cases,serum uric acid decreased in 3 cases,and serum sodium chloride decreased in 2 cases.The adverse reaction rate was 25%,and the difference was statistically significant(P<0.05).Conclusion For patients with chronic heart failure,on the basis of conventional anti-heart failure,tolasemide treatment can significantly improve the total effective rate,improve biochemical indicators,enhance cardiac function,and has a high safety,clinical guidance application value is very significant.