托拉塞米治疗AECOPD患者心力衰竭的临床疗效及安全性分析

目的：探讨托拉塞米在治疗慢阻肺疾病急性发作期（AECOPD）患者心力衰竭的临床疗效及安全性分析。方法：选择武汉市汉口医院2012年1月-2017年1月收治的慢阻肺急性发作期患者74例。随机分成对照组和观察组各37例，在常规治疗及对症治疗的基础上观察组给予托拉塞米（南京海辰药业有限公司生产）10 mg静脉推注；对照组给予呋塞米（山东圣鲁制药有限公司生产）20 mg静脉推注，每日1次，连续使用5 d。分析两组治疗前后的24 h尿量、BNP测值、不良事件发生率。结果：治疗前对照组与观察组差异不明显；两组患者治疗前尿量的差异无显著性（P>0.05），治疗前与治疗第5天后，两组比较尿量均较治疗前增加，差异有显著性（P<0.05），但观察组与对照组比较，尿量增加对比，差异有显著性（P<0.05）；两组治疗后BNP的下降比较有显著性差异（P<0.05﹚， 治疗组总不良反应发生率为13.5%。对照组总不良反应发生率为32.4%。差异有显著性（P<0.05）。结论：短期静脉推注托拉塞米比呋塞米更有效缓解症状，改善心脏功能，更有效降低BNP，且不良反应发生率低，更安全有效。

Clinical efficacy and safety of torasemide in the treatment of heart failure in patients with AECOPD

OBJECTIVE To investigate the clinical efficacy and safety of torasemide in the treatment of heart failure in patients with chronic obstructive pulmonary disease (AECOPD).METHODS Totally 74 patients with acute COPD admitted from January 2012 to January 2017 in Wuhan Hankou Hospital were selected,randomly divided into the control group and the observation group,with 37 cases in each.On the basis of conventional treatment and symptomatic treatment,patients in the observation group were given torasemide (Nanjing Haichen Pharmaceutical Co.,Ltd.) 10mg intravenous injection; patients in control group given furosemide (Shandong Shenglu Pharmaceutical Co.,Ltd.) 20 mg intravenous injection once daily for 5 days.The 24-hour urine volume,BNP values,and incidence rates of adverse events before and after treatment were analyzed.RESULTS Before treatment,there was no significant difference between the control group and the observation group (P>0.05).After the treatment,the urine volumes of the two groups increased compared with those before treatment (P<0.05).There were statistically significant difference in the urine volume (P<0.05),the decrease of BNP (P<0.05),and overall incidence rates of adverse reactions (treatment group 13.5% vs.control group 32.4%) (P<0.05) between two groups after treatment.CONCLUSION Short-term intravenous push torasemide is more effective than furosemide in relieving symptoms,improving cardiac function,and more effective in reducing BNP.The incidence of adverse reactions is low,safer and more effective.