托拉塞米对重度心力衰竭的短期临床疗效观察

目的探讨托拉塞米对重度心力衰竭的短期临床疗效及副作用。方法58例重度心力衰竭分为托拉塞米组与呋塞米组，在心衰常规治疗方法相同的情况下，比较两组对心衰患者总有效率、尿量、浮肿消退、血钾、血钠、血Cr变化。结果托拉塞米组总有效率明显优与呋塞米组（93．7％ vs 82．1％P〈0．05）存在显著性差异；尿量（2600ml vs 2100ml），存在显著差异（P〈0．05）；浮肿消退：托拉塞米组明显消退95．8％，呋塞米组63．6％存在显著差异（P〈0．05）．在每日补钾相同情况下，托拉塞米组血钾上升0．2mmol·L^-1未发生新的低血钾，呋塞米组血钾下降0．1mmol·L^-1低血钾发生率两组存在显著差异（P〈0．05），两组对血钠、血Cr影响无显著性差异。结论托拉塞米对重度心力衰竭患者有较好的短期疗效、利尿作用强、浮肿消退率高、副作用相对较少。

Short-term curative effect of torasemide on serious heart failure patients

Aim To explore short-term clinical and side effects of torasemide on serious heart failure patients. Methods Fifty-eight patients with New York Heart Association （NYHA） class Ⅲ or Ⅳ congestive heart failure were divided into two groups, the torasemide group and the furosemide group. Total effective rate, uria volume, disappearance of edema, serum potassium, sodium and creatinine were compared. Results The total effect of the torasemide group is superior to the furosemide group（93.7% vs 82.1% P 〈 0.05 ）. The deviation is significient. There are also significient differences between two groups in uria volume（2 600 ml vs 2 100 ml P 〈0.05 ） ,disappearance of edema（95.8% vs 63.6% P 〈 0.05 ）. On the same condition of supplement of potassium everyday,serum potassium of the torasemide group increase by 0.2 mmol · L^-1 without new hypopotassemia while that of furosemide group decline by 0. 1 mmol · L^-1. There exists different rate of hypopotassemia between two groups. There is no difference between two groups in serum sodium and creatinine. Conclusion Torasemide has better short-term clinical curative effect on serious congestive heart failure than that of furosemide.