持续静脉滴注速尿治疗充血性心力衰竭随机对照研究.pdfVIP

ÇhineseJournalof Cardiovascular Medicine ,August 2002. Vol 7. No. 4 持续静脉滴注速尿治疗充血性心力衰竭随机对照研究 曾朝荣石卫晨何辉兰永乔陈兵阳林琦 刘 E景喻陈维永郝科丁锦云李悦林李艳 摘要:目的 探讨持续静脉滴注速尿治疗充血性心力衰竭(CHF) 的药效学及对生理平衡的影响是否优于一次性注射治 疗。方法 采用随机对照方法将 70 例 NYHA 心功能 m-IV 级CHF 患者分为持续静脉滴注组(静滴组.35 例)和一次性 静脉注射组(静注组.35 例) ，静滴组在注射 10mg 负荷剂量速尿后持续静滴 30mg ，静注组一次性注射 40mg ，均持续 3 日。治疗前后分别评价心功能及血生化指标，并计算每日尿量和尿 K+ ， Na+ 、 Cl 排泄量。结果 静滴组每日尿量及尿 K+ ， Na+ 、Cl-排泄量均明显大于静注组，尤其在治疗的第二日、第三日，治疗后静注组除血脂浓度升高比静滴组更显著 外，其他生化指标两组无显著差异。结论 持续静脉滴注速尿治疗CHF 在药效学方面明显优于静脉注射方式，并可提高 肾脏对速尿的敏感性，延缓耐受性的产生。对生理平衡的影响也可能优于一次性静脉注射，值得进一步探讨。 关键词: 速尿; 持续静脉滴注: 充血性心力衰竭; 药效学; 生理影响 A randomized-controlled study on continuous furosemide infusion in the treatment of patients with congestive heart failure Zellg Chωrong. Shi Weichen , He Hui , et al. Chellgdu Seventh Peo户的 Hosþital. Chellgdu 610021 Abstract: Objective To assess the pharmacodynamic and physiological effects of continuous furosemide infusion compared with IV bolus injection in the treatment of patients with congestive Heart failure (CHF). Methods 70 pa- tients with CHFCNYHA classes m -IV) were randomized assigned to one of two groups. One group (35 patients) were preceded by IV bolus injection of loading dose of 10mg furosemide followed immediately by a continuous infu- sion for 30mg . Another group (35 patients) were treated with IV bolus injections of 40mg furosemide. The treat- ment period in two groups were 3days . The information of heart function classes and blood physiochemical index were determined before and after treatment. the urinary volume , urinary K+ .Na+ .Cl- excretion for 24hours were co Ilected everyday. Results The urinary volume. urinary K +、 Na+ ,Cl- excretion for 24hours were significantly gr