托拉塞米与呋塞米治疗2型糖尿病并发心力衰竭的疗效比较

目的:比较托拉塞米与呋塞米在2型糖尿病(T2DM)并发心力衰竭患者中的疗效、安全性和对血糖代谢的影响.方法:75例T2DM并发心力衰竭患者随机分为托拉塞米(38例.10 mg/次)组和呋塞米(37例.20 mg/次)组,并每日1～2次利尿,观察治疗1周后平均24h尿增加量、射血分数值改普及血钾下降幅度,1周内空腹血糖波动以及不良反应等指标.结果:托拉塞米组平均24h尿增加量,血钾和血糖稳定性均优于呋塞米组(P＜0.05)；两组心功能均有改善,低血压和肝肾功能损害无差别,低血钾和低血糖发生率明显少于呋塞米组(P＜0.05).结论:在T2DM并发心力衰竭中,托拉塞米比呋塞米具有更好的作用和更高的安全性.

Effect Comparison between Torasemide and Furosemide in the Treatment of Patients with Type 2 Diabetes Mellitus Complicated with Heart Failure

Objective:To compare the effect,safety and impact on blood glucose by torasemide and furosemide in the treatment of patients with type 2 diabetes mellitus(T2DM)complicated with heart failure.Methods:Seventy-five subjects were allocated randomly to torasemide(10 mg one time)and furosemide(20 mg one time)groups,once or twice a day for diuresis.The indexes studied were 24-hour urine volume,the improvement of ejection fraction(EF),fasting glucose and side effects in the following week.Results:The urine volume and the stability of blood potassiumion and blood glucose in the torasemide group were significantly better than those in the furosemide group(P<0.05).The hypotension,liver and kidney disfunction were no difference between two groups.The incidence of hypopotassaemia and hypoglycemia in the torasemide group was significantly lower than in the furosemide group(P<0.05).Conclusion:Torasemide has greater curative effect and higher safety than furosemide in the treatment of patients with type T2DM complicated with heart fai-lure.