托拉塞米联合乌拉地尔治疗慢性心力衰竭的临床研究

Clinical study on torasemide combined with urapidil in treatment of chronic heart failure

目的探讨托拉塞米联合乌拉地尔治疗慢性心力衰竭的临床疗效。方法选取2019年1月—2021年1月在宝鸡高新医院住院治疗的96例慢性心力衰竭患者,随机分为对照组(48例)和治疗组(48例)。对照组静脉滴注乌拉地尔注射液,25 mg加入生理盐水100 mL,1次/d。治疗组患者在对照组的基础上口服托拉塞米片,10 mg/次,1次/d。两组患者连续治疗7 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状缓解时间,心功能指标左室舒张末期内径(LVEDD)、左室射血分数(LVEF)和脑钠肽(BNP)水平,血清炎性因子白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)水平及不良反应情况。结果治疗后,治疗组患者总有效率明显高于对照组(97.92%vs 81.25%,P<0.05)。治疗后,治疗组患者症状缓解时间均早于对照组(P<0.05)。治疗后,两组患者LVEDD、BNP指标明显下降,而LVEF明显升高(P<0.05),且治疗组患者心功能指标水平明显好于对照组(P<0.05)。治疗后,两组患者IL-6、TNF-α、CRP水平明显降低,而IL-10水平明显升高(P<0.05),且治疗组患者炎性因子水平明显好于对照组(P<0.05)。治疗组药物不良反应发生率明显低于对照组(8.33%vs 16.67%,P<0.05)。结论托拉塞米联合乌拉地尔治疗慢性心力衰竭临床效果较好,能增强患者心功能,并有效抑制炎性因子释放,降低不良反应发生率。

Objective To investigate the efficacy of torasemide combined with urapidil in treatment of chronic heart failure. Methods Patients(136 cases) with chronic heart failure in Baoji High Tech Hospital from January 2019 to January 2021 were randomly divided into control(48 cases) and treatment(48 cases) groups. Patients in the control group were iv administered with Urapidil Injection, 25 mg added into 100 mL normal saline, once daily. Patients in the treatment group were po administered with Torsemide Tablets, 10 mg/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the relief time of clinical symptom, the levels of cardiac function indicators LVEDD, BNP, and LVEF, the levels of inflammatory factors IL-6, TNF-α, CRP, and IL-10, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group(97.92% vs 81.25%, P < 0.05).After treatment, the time of symptom relief in the treatment group was earlier than that in the control group(P < 0.05). After treatment,the indexes of LVEDD and BNP were significantly decreased, while LVEF were significantly increased in two groups(P < 0.05), and the level of cardiac function in the treatment group was significantly better than that in the control group(P < 0.05). After treatment,the levels of IL-6, TNF-α and CRP in two groups were significantly decreased, while the level of IL-10 were significantly increased(P < 0.05), and the level of inflammatory factors in the treatment group was significantly better than that in the control group(P <0.05). The incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group(8.33% vs 16.67%, P < 0.05). Conclusion The clinical effect of torasemide combined with urapidil in treatment of chronic heart failure is good,which can enhance the cardiac function of the patients, effectively inhibit the release of inflammatory factors and reduce the incidence of adverse reactions.