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目的:探讨50%葡萄糖静注联合持续泵入呋塞米治疗顽固性心力衰竭临床效果。方法:62例顽固性心力衰竭患者随机分成联合治疗组和对照组,每组31例,联合治疗组采取50%葡萄糖100 m L静注联合呋塞米100 mg持续静脉泵入,对照组采取呋塞米300 mg间断注射。记录两组患者临床治疗效果,比较两组患者治疗前后24小时尿量、脑利钠肽、心脏指数(CI)、左心室舒张期前后径(LVEDD)和左室射血分数(LVEF)变化情况。结果:联合治疗组患者临床效果总有效率90.3%,远高于对照组64.5%(P<0.05);治疗后,两组患者24 h尿量均有所增加,BNP浓度均有所减少,差异均具有统计学意义(均P<0.05),联合治疗组患者24 h尿量多于对照组,BNP浓度少于对照组,差异均具有统计学意义(均P<0.05),两组患者CI和LVEF均较治疗前提高(均P<0.05),而LVEDD较治疗前差异无统计学意义(P>0.05),联合治疗组患者CI和LVEF提高程度均高于对照组(均P<0.05)。结论:50%葡萄糖静注联合持续泵入呋塞米治疗顽固性心力衰竭短期临床效果显著,能够明显减少水钠潴留,减轻水肿,改善心脏功能。
Objective: To investigate the clinical effect of continuous infusion of 50% glucose intravenous furosemide on refractory heart failure. Methods: Sixty-two patients with refractory heart failure were randomly divided into combined treatment group and control group, with 31 cases in each group. The combined treatment group was given 100% glucose and 100 mg intravenous furosemide, and the control group received furosemide Simi 300 mg intermittent injection. The clinical effects of two groups of patients were recorded. The changes of urine volume, brain natriuretic peptide, cardiac index (CI), left ventricular diastolic anteroposterior diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the two groups before and 24 hours after treatment . Results: The total effective rate was 90.3% in the combined treatment group, which was much higher than that in the control group (64.5%, P <0.05). After treatment, the urine output of 24 h increased and the BNP concentration decreased (All P <0.05). The urine output of patients in the combined treatment group was more than that of the control group at 24 hours, and the BNP concentration was lower than that of the control group (all P <0.05). The CI and LVEF were significantly higher than those before treatment (all P <0.05), while there was no significant difference in LVEDD between before and after treatment (P> 0.05). The levels of CI and LVEF in combination therapy group were higher than those in control group (all P <0.05). Conclusion: 50% glucose intravenous infusion combined with furosemide in the treatment of refractory heart failure has a short-term clinical effect, which can significantly reduce water and sodium retention, reduce edema and improve cardiac function.