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目的重症肺炎合并心力衰竭临床上具有较高的发病率与病死率,应引起极大的重视。观察氯噻嗪与氯丙嗪联合辅助治疗重症肺炎合并心力衰竭临床影响情况。方法选取自2010年4月-2012年3月以来入该院治疗重症肺炎合并心力衰竭患者149例,随机分为试验组75例和对照组74例。对照组使用药物主要为强心、血管扩张剂等常规治疗。试验组80例在常规治疗基础之上加入氯噻嗪与氯丙嗪,连续治疗15d观察疗效。结果试验组有效率高于对照组,病情持续恶化率和病死率均低于对照组,差异均有统计学意义(P<0.05)。结论氯噻嗪主要作用在肾脏的远曲小管,抑制钠的重吸收,增加肾脏排泄,降低血压,迅速降低重症肺炎合并心力衰竭患者的心脏负荷;加入小剂量的氯丙嗪有助于增强重症肺炎合并心力衰竭患者的休息质量,感少患者因自身能量削耗造成的免疫降低而引起的病情加重。
Objectives Severe pneumonia complicated with heart failure has a high morbidity and mortality rate, which should arouse great attention. To observe the clinical effect of chlorothiazide and chlorpromazine in adjuvant treatment of severe pneumonia complicated with heart failure. Methods From April 2010 to March 2012, 149 cases of severe pneumonia complicated with heart failure admitted to the hospital were randomly divided into experimental group (75 cases) and control group (74 cases). Control group used drugs mainly cardiac, vasodilators and other conventional treatment. Eighty patients in the experimental group were treated with chlorothiazide and chlorpromazine on the basis of routine treatment, and the curative effect was observed after continuous treatment for 15 days. Results The effective rate of the experimental group was higher than that of the control group, and the rate of continuous deterioration and mortality was lower than that of the control group (P <0.05). Conclusion Chlorothiazide acts mainly in the distal convoluted tubules of the kidneys, inhibits sodium reabsorption, increases renal excretion, lowers blood pressure and rapidly reduces cardiac load in patients with severe pneumonia and heart failure. Adding a small dose of chlorpromazine helps to increase severe symptoms The quality of rest in patients with pneumonia complicated with heart failure, and the feeling of less suffering from reduced immunity due to their own energy consumption, are exacerbated.