托拉塞米联合血液净化治疗肾病综合征水肿患者的疗效及安全性研究

Efficacy and safety of torsemide combined with blood purification in patients with nephrotic syndrome edema

目的:探讨托拉塞米联合血液净化治疗肾病综合征(nephrotic syndrome,NS)水肿患者的疗效及安全性。方法:选取150例NS水肿住院患者随机分为对照组、静脉注射组和恒速泵静脉滴注组各50例,静脉注射组予托拉塞米2 min静脉注射治疗,恒速泵静脉滴注组给予2 h恒速泵静脉滴注治疗,在应用托拉塞米治疗的同时均予以血液净化治疗,对照组给予单独血液净化治疗。观察各组治疗效果和不良反应情况。结果:与静脉注射组比较,恒速泵静脉滴注组结合态托拉塞米的量显著减少(P<0.01),24 h尿量与24 h托拉塞米排泄总量的比值明显升高(P<0.01)。恒速泵静脉滴注组的AUC明显高于静脉注射组,且表观容积(Vd)较低(P<0.01)。应用托拉塞米的两组临床疗效明显优于对照组(P<0.05)。3组均无严重不良反应发生。结论:托拉塞米联合血液净化治疗NS水肿患者的疗效显著,安全性较高,且2 h恒速泵静脉滴注给药方案效果更优。

Objective:To investigate the efficacy and safety of torsemide combined with blood purification in the treatment of nephrotic syndrome(NS)edema.Methods:One hundred and fifty cases of the hospitalized patients were randomly divided into a control group,an intravenous injection group and a constant speed pump intravenous drip group with 50 cases each.The patients were treated with torsemide for 2 min in the intravenous injection group and with torsemide for 2 h in the constant speed pump intravenous drip group when they were given blood purification treatment,and the control group was given only blood purification treatment.The therapeutic effect and adverse reaction were observed in each group.Results:The amount of torsemide was significantly decreased(P<0.01)and the ratio of 24 h urine output to 24 h total torsemide excretion was significantly increased(P<0.01)in the constant speed pump intravenous drip group compared with the intravenous injection group.AUC were significantly higher and the apparent volume was lower in the constant speed pump intravenous drip group than the intravenous injection group(P<0.01).The clinical efficacy was significantly better in the two groups using torsemide than the control group(P<0.05).No serious adverse reactions occurred in any of the 3 groups.Conclusion:Torsemide combined with blood purification is effective and safe in the treatment of NS patients with edema,and the infusion regimen of 2 h constant speed pump is more effective.