托拉塞米在急性左心衰竭伴低钾血症中的临床应用

摘要

目的：探讨托拉塞米在急性左心衰竭伴低钾血症的患者中应用的疗效观察。方法将60例急性左心衰竭伴低钾血症患者随机分为观察组和对照组，每组30例，在常规的抗心力衰竭药物治疗基础上，观察组给予生理盐水20 mL+托拉塞米针10 mg，静脉注射，每日1次；对照组予生理盐水20 mL+呋塞米针20 mg静脉注射，每日1次，两组疗程均为3 d。观察两组患者在治疗3 d后血压、心率、24 h尿量、血钾血钠指标的变化水平，同时进行临床疗效评定。结果①治疗前后，两组患者在血压值、心率值和血钠水平的变化方面，无统计学意义（P＞0.05）。②治疗后，观察组的24 h尿量为（3126±316）mL，相比对照组为（2684±302）mL，24 h尿量变化有统计学意义（P<0.05）；治疗后，观察组的血钾为（2.98±0.29）mmol/L mL，相比对照组为（2.88±0.26）mmol/L，24 h血钾变化有统计学意义（P<0.05）。③治疗前后，两组均进行心力衰竭疗效评定，观察组的总有效率（96.7%）明显高于对照组（70.0%），差异有统计学意义（P<0.05）。结论在急性左心衰竭伴低钾血症患者中，托拉塞米对心力衰竭的改善有肯定的临床疗效，而且对血钾水平影响较小。%Objective To observe therapeutic effect of Torasemide in Treating ALHF(Acute Left Heart Failure)complicated with Hypokalemia Methods 60 patients with ALHF complicated with hypokalemia were divided randomly into two groups with 30 members each. Along with conventional treating medications, for 3 days, observational group were given both NS(normal saline)20 mL and Torasemide 10mg by Intravenous injection once a day, while control group were given NS 20 mL and Frosemide 20mg by intravenous injection once a day. Then, changes of heart pressure, heart rate, urine volume in 24 hours, serum potassium and the serum sodium levels were observed and clinical effectiveness was being evaluated. Results ①It is of no statistical significance(P>0.05)in changes of patients’ heart pressure, heart rate and serum sodium levels before and after treatment.②After treatment, urine volume in 24 hours in observation group was (3126±316)mL,compared with that of(2684±302)in control group, which is of statistical significance(P<0.05);change of serum potassium in 24 hours in observational group was(2.98±0.29)mmol/L compared with that of (2.88±0.26)mmol/L in control group, which is of statistical significance(P<0.05).③Assessed before and after treatment, the curative effect in observational group was(96.7%), significantly higher than that of control group(70.0%), which is of statistical significance (P<0.05). Conclusion In treating patients with ALHF complicated with hypokalemia, Torasemide is quite effective clinically in treating heart failure but has limited effect on serum potassium level.