盐酸特拉唑嗪片联合呋塞米注射液对输尿管上段结石ESWL患者的临床疗效分析

Clinical efficacy of terazosin hydrochloride tablets combined with furosemide injection on patients with upper ureteral calculi underwent ESWL

目的 研究盐酸特拉唑嗪片联合呋塞米注射液对输尿管上段结石体外冲击波碎石术(ESWL)患者炎症应激、疼痛程度和肾功能影响。方法 选取输尿管上段结石患者,按照就诊顺序将患者编号,并采用随机数字表分为试验组和对照组,2组均采用ESWL治疗进行治疗,于术后第1天起给予呋塞米静脉注射,每次20 mg,qd,疗程3 d,试验组另加用盐酸特拉唑嗪片口服,每次2 mg,qd,疗程2周,比较2组结石清除率、症状体征、氧化应激、炎症反应和肾功能。结果 2组试验过程中均无病例脱落,最终试验组和对照组分别纳入46例。治疗后,试验组和对照组2周结石清除率分别为82.61%(38例/46例)和63.04%(29例/46例),二次ESWL率分别为13.04%(6例/46例)和30.43%(14例/46例);试验组和对照组血尿消失时间分别为(4.29±0.73)和(4.86±0.78)d,腰痛消失时间分别为(6.45±1.62)和(7.04±1.59)d;试验组和对照组术后7 d数字评分法(NRS)评分分别为(1.39±0.43)和(1.85±0.46)分;试验组和对照组术后14 d时血清氧化物歧化酶(SOD)分别为(91.25±24.79)和(103.42±26.83)U·mL^(-1),丙二醛(MDA)分别为(3.82±0.96)和(4.39±1.57)μmol·mL^(-1),白细胞介素-6(IL-6)分别为(96.05±21.62)和(105.73±23.15)ng·mL^(-1),肿瘤坏死因子-α(TNF-α)分别为(1.08±0.21)和(1.26±0.29)μg·mL^(-1),C反应蛋白(CRP)分别为(10.27±2.54)和(12.53±2.81)mg·mL^(-1),试验组上述指标与对照组比较,差异均有统计学意义(均P<0.05);治疗期间,试验组药物不良反应为恶心2例,腹痛3例,心悸1例;对照组药物不良反应为腹痛2例,心悸1例;试验组和对照组药物不良反应发生率分别为13.04%(6例/46例)和6.52%(3例/46例),试验组与对照组比较,差异有统计学意义(P<0.05)。结论 盐酸特拉唑嗪联合呋塞米用于输尿管上段结石ESWL术后治疗具有良好效果,可有效提升结石清除率,缓解机体氧化应激和炎症水平,促进肾功能恢复。

Objective To study the effects of terazosin hydrochloride tablets combined with furosemide injection on inflammatory stress,pain degree and renal function in patients undergoing extracorporeal shock wave lithotripsy (ESWL) for upper ureteral calculi.Methods Patients with upper ureteral calculi were selected and numbered according to the diagnosis order and then divided into treatment group and control group by the random number table method.Both groups were treated by ESWL and given intravenous injection of furosemide (20 mg every time,qd,3 days) on the 1^(st)day after surgery,and the treatment group was additionally given terazosin hydrochloride tablets orally(2 mg every time,qd,2 weeks).The stone clearance rate,symptoms and signs,oxidative stress,inflammatory response and renal function were compared between the two groups.Results No cases were shed in the 2 groups during the trail,and 46 cases were included in treatment group and control group,respectively.After treatment,the 2-week stone clearance rates in treatment group and control group were 82.61%(38 cases/46 cases) and 63.04%(29 cases/46 cases),respectively,and the secondary ESWL rates were 13.04%(6 cases/46 cases) and 30.43%(14 cases/46 cases).The disappearance times of hematuria in treatment group and control group were (4.29±0.73)and (4.86±0.78) d,and the disappearance times of lumbago were (6.45±1.62) and (7.04±1.59) d,respectively;the numerical rating scale (NRS) scores were (1.39±0.43) and (1.85±0.46) at 7 days after surgery respectively.Serum levels of superoxide dismutase (SOD) in treatment group and control group at 14 days after surgery were (91.25±24.79) and (103.42±26.83) U·mL^(-1),and levels of malondialdehyde (MDA) were(3.82±0.96) and (4.39±1.57)μmol·mL^(-1),and levels of interleukin-6 were (96.05±21.62) and(105.73±23.15) ng·mL^(-1),and levels of tumor necrosis factor α (TNF-α) were (1.08±0.21) and(1.26±0.29)μg·mL^(-1),and levels of C-reactive protein (CRP) were (10.27±2.54) and (12.53±2.81)mg·mL^(-1),there were significant differences in the above indexes between the treatment group and the control group(all P<0.05).During treatment,there were 2 cases of nausea,3 cases of abdominal pain and 1 case of palpitation in treatment group,and there were 2 cases of abdominal pain and 1 case of palpitation in control group,and the incidence rates of adverse drug reactions in treatment group and control group were 13.04%(6 cases/46 cases) and 6.52%(3 cases/46 cases),respectively (P<0.05).Conclusion Terazosin hydrochloride talets combined with furosemide has a good effect in the ESWL postoperative treatment of upper ureteral calculi,and it can effectively improve the stone clearance rate,relieve the body’s oxidative stress and inflammation level,and promote the recovery of renal function.