托拉塞米注射液治疗中老年慢性肾衰竭伴水肿患者的临床病例分析

目的：观察托拉塞米注射液治疗中老年慢性肾衰竭伴水肿患者的疗效及其对代谢指标的影响。方法 收集长春市中心医院肾病科2008年5月～2009年9月期间慢性肾衰竭伴水肿，应用托拉塞米注射液的患者，年龄在42～82岁之间。按照慢性肾衰竭诊断标准，分4组：1组：肾功能代偿期，21例；2组：肾功能失代偿期，24例；3组：肾功能衰竭期，15例；4组：尿毒症期，12例。观察各组应用托拉塞米前后的24h尿量、体罩、水肿及各代谢指标的变化。结果：①1组和2组患者应用托拉塞米后较用药前水肿消退（P〈0．01），尿量明显增加（P〈0．01）。②3组患者应用托拉塞米后较用药前水肿消退（P〈0．01），尿量呈增加趋势，但没有统计学差异。③4组患者应用托拉塞米后较用药前水肿消退（P〈0．01），尿量明显增加（P〈0．05）。④各组患者应用托拉塞米前后体重、血压、空腹血糖、血尿酸、血钾、尿素氮及血肌酐均无显著变化。结论：托拉塞米注射液能增加中老年慢性肾衰竭伴水肿患者的尿量并减轻水肿，对代谢指标没有显著影响。

Clinical Analysis of Therapeutic Effect of Torasemide Injection in Elderly Patients with Chronic Renal Failure Combined with Edema

OBJECTIVE： To observe the therapeutic effect of Torasemide injection in older people with chronic renal failure （CRF） combined with edema and to observe the impact of Torasemide injection on metabolic indexes. METHODS： A total of the pa- tients （42 to 82 years） with CRF combined with edema who were treated with Torasemide injection during the period from May 2008 to September 2009 in our hospital were in this study. The patients enrolled in this study were in accordance with diagnostic criteria for CRF and were divided into four groups ： （ 1 ） Patients in compensated stage group （ n = 21 ） ; （ 2 ） Patients in uncompensated stage group （n =24） ; （3） Patients with renal failure group （n = 15） ; （4） Patients with uremia group （n --12）. Urine volume, body weight, edema and other metabolic indexes within 24 hours among all the groups before and after Torasemide treatment were studied. RESULTS： Edema was removed more obviously （P 〈 0. 01 ） and urine volume was higher in the groups after Torasemide treatment than before Torasemide treatment, but urine volume had no significant differences in groups. CONCLUSIONS： Urine volume is increased and edema is removed in the elderly patients with CRF combined with edema after treatment with Torasemide injection.