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目的观察托拉塞米对慢性心力衰竭(CHF)心功能Ⅲ~Ⅳ级患者预后的影响。方法 93例CHF心功能Ⅲ~Ⅳ级患者,采用隐匿数字随机法分为观察组(47例)和对照组(46例)。入院后均给予相同的基础治疗,观察组患者利尿剂采用托拉塞米,对照组患者采用呋塞米,比较两组患者患者水肿、呼吸困难等症状缓解和消失时间、不良反应、24 h尿量增加量;出院后随访12个月,比较两组患者因心力衰竭加重引起的死亡例数、再次住院频度。结果观察组患者主要症状缓解时间、主要症状消失时间均短于对照组,24 h尿量增加大于对照组,再次住院频度少于对照组,差异均具有统计学意义(P<0.05)。随访12个月,观察组因心力衰竭加重引起的死亡5例,死亡率为10.64%;对照组死亡13例,死亡率为28.26%,比较差异具有统计学意义(P<0.05)。观察组低血钾发生率为6.38%,低于对照组的21.74%,差异具有统计学意义(P<0.05)。结论托拉塞米对CHF心功能Ⅲ~IV级患者预后改善有显著的作用,而且安全性更好。
Objective To observe the effect of torsemide on the prognosis of patients with grade Ⅲ ~ Ⅳ cardiac function in patients with chronic heart failure (CHF). Methods A total of 93 CHF patients with grade Ⅲ ~ Ⅳ cardiac function were divided into the observation group (n = 47) and the control group (n = 46) by occult digital randomization. The same basic treatment was given after admission. The patients in the observation group received torsemide with diuretic and the control group with furosemide. The edema, dyspnea and other symptoms in both groups were relieved and disappeared, adverse reactions, 24 h urine The patients were followed up for 12 months after discharge from hospital, and the number of deaths caused by the worsening of heart failure was compared between two groups. Results The main symptom relief time and disappearance of main symptoms in the observation group were shorter than those in the control group. The urine output in 24 hours increased more than that in the control group, and the frequency of hospitalization was less than that in the control group. The difference was statistically significant (P <0.05). In the 12-month follow-up, 5 deaths caused by heart failure were observed in the observation group, with a mortality rate of 10.64%. Thirteen deaths were found in the control group with a mortality rate of 28.26%. The difference was statistically significant (P <0.05). The incidence of hypokalemia in the observation group was 6.38%, which was lower than that in the control group (21.74%), the difference was statistically significant (P <0.05). Conclusion Torsemide has a significant effect on improving the prognosis of CHF patients with grade III-IV heart failure and is more safe.