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目的:观察托拉塞米注射液治疗中老年慢性肾衰竭伴水肿患者的疗效及其对代谢指标的影响。方法:收集长春市中心医院肾病科2008年5月～2009年9月期间慢性肾衰竭伴水肿,应用托拉塞米注射液的患者,年龄在42～82岁之间。按照慢性肾衰竭诊断标准,分4组:1组:肾功能代偿期,21例;2组:肾功能失代偿期,24例;3组:肾功能衰竭期,15例;4组:尿毒症期,12例。观察各组应用托拉塞米前后的24h尿量、体重、水肿及各代酣指标的变化。结果:①1组和2组患者应用托拉塞米后较用药前水肿消退(P<0.01),尿量明显增加(P<0.01)。②3组患者应用托拉塞米后较用药前水肿消退(P<0.01),尿量呈增加趋势,但没有统计学差异。③4组患者应用托拉塞米后较用药前水肿消退(P<0.01),尿量明显增加(P<0.05)。④各组患者应用托拉寨米前后体重、血压、空腹血糖、血尿酸、血钾、尿素氮及血肌酐均无显著变化。结论:托拉塞米注射液能增加中老年慢性肾衰竭伴水肿患者的尿量并减轻水肿,对代谢指标没有显著影响。
Objective: To observe the efficacy of torsemide injection in the treatment of middle-aged and elderly patients with chronic renal failure and edema and its influence on the metabolic parameters. Methods: Patients with chronic renal failure and edema from May 2008 to September 2009 in Changchun Central Hospital were enrolled. Patients with torasemide injection were aged 42-82 years old. According to the diagnostic criteria of chronic renal failure, there were 4 groups: group 1: compensated renal function in 21 cases; group 2: decompensated renal function in 24 cases; group 3: renal failure, 15 cases; group 4: Uremic period, 12 cases. The 24h urine volume, body weight, edema and changes of pericardial index were observed before and after torsemide administration in each group. Results: (1) The use of torsemide after administration of torsemide reduced the edema (P <0.01) and the urine output (P <0.01) in group 1 and group 2 after treatment. ② After using torsemide, the edema of the three groups subsided (P <0.01) and the urine output increased, but there was no statistical difference. (4) The use of torsemide in 4 groups subsided compared with that before treatment (P <0.01), and urine output increased significantly (P <0.05). ④ The body weight, blood pressure, fasting blood glucose, serum uric acid, serum potassium, urea nitrogen and serum creatinine had no significant changes before and after application of tolazamil in each group. Conclusion: Torsemide injection can increase urine output and reduce edema in elderly patients with chronic renal failure and edema, and has no significant effect on metabolic parameters.