口服托拉塞米与呋塞米在心力衰竭维持治疗中疗效的比较

Comparison of the efficacy of oral torasemide and furosemide in the maintenance treatment of heart failure

目的比较口服托拉塞米与呋塞米在心力衰竭维持治疗中的疗效。方法50名成年心力衰竭患者随机分为呋塞米组合(25例)和托拉塞米组(25例),两组患者均接受心衰标准治疗方案,分别以呋塞米20 mg·d^(-1)、托拉塞米10 mg·d^(-1)维持治疗,随访1年。观察2组患者因心衰再住院率、再住院时间、住院天数、药物不良反应、躯体和情绪状况评分。结果呋塞米组23名患者完成随访,托拉塞米组24名患者完成随访。与呋塞米组相比,托拉塞米组患者因心衰再住院率低,且住院天数少(P<0.05)。Kaplan-Meier生存分析显示,托拉塞米组患者再住院的风险低于呋塞米组患者(P<0.05),COX回归分析发现,托拉塞米组患者再住院风险降低62%(P<0.05)。两组患者不良反应发生率无明显差异。出院后2个月、8个月、12个月托拉塞米组患者躯体状况评分改善较呋塞米组明显(P<0.05)。两组患者情绪状况评分改善无统计学差异。结论在心力衰竭维持治疗中托拉塞米疗效好于呋塞米,能降低患者再住院风险,降低住院天数,改善心衰患者躯体状况评分,但需要更多临床研究数据来验证。

Objective To compare the efficacy of oral torasemide and furosemide in the maintenance treatment of chronic heart failure.Methods 50 adult patients with chronic heart failure were randomly divided into furosemide group(n=25)and torasemide group(n=25).Both groups received standard treatment regimen for heart failure,and were maintained with furosemide 20 mg·d^(-1) and torasemide 10 mg·d^(-1),respectively,and were followed up for 1 year.The readmission rate for heart failure,readmission time,hospital days,adverse effects,physical and emotional scores of patients with heart failure were observed in the two groups.Results 23 patients in furosemide group and 24 patients in torasemide group were followed up.Compared with furosemide group,the readmission rate of torasemide group was lower and the hospital days were less than that of furosemide group(P<0.05).Kaplan-Meier survival analysis showed that the risk of readmission in the torasemide group was lower than that in the furosemide group.COX proportional hazards regression analysis showed that the risk of readmission in the torasemide group was reduced by 62%(P<0.05).There was no significant difference in the adverse events between the two groups.At 2 months,8 months and 12 months after discharge,the physical score of patients in torasemide group was significantly better than that in furosemide group(P<0.05).There was no significant difference in the improvement of emotional score between the two groups.Conclusion Torasemide was better than furosemide in the maintenance treatment of chronic heart failure,which can reduce the risk of readmission,reduce the hospital days and improve the physical score of patients with heart failure.Further studies were needed to support this data.