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目的观察螺内酯治疗肝硬化腹水的临床疗效。方法 78例中度肝硬化腹水患者,随机分为不限钠饮食组和限钠饮食组各39例。单用螺内酯利尿,首剂100mg/d,若治疗无效,每3～5d增量1次,逐渐加量至最大剂量400mg/d,并监测体重、尿量、肾功能、电解质、24h尿钠排泄量。结果螺内酯治疗后,限钠组血钠水平明显降低,24h尿钠排泄增加量低于不限钠饮食组,但两组开始起效时间、显效所需时间差异均无统计学意义。不限钠饮食组35例(89.7%)有效,限钠饮食组34例(87.2%)有效,总有效率为88.5%。结论单用螺内酯利尿效果较满意,安全性良好,饮食限钠未增强利尿效果,故不宜提倡限钠饮食。
Objective To observe the clinical efficacy of spironolactone in the treatment of liver cirrhosis with ascites. Methods Seventy-eight patients with moderate cirrhosis and ascites were randomly divided into three groups: sodium-free diet group and sodium-limited diet group. Single spironolactone diuretic, the first dose of 100mg / d, if the treatment is invalid, every 3 ~ 5d incremental 1, gradually increase the maximum dose of 400mg / d, and monitoring body weight, urine output, renal function, electrolytes, 24h urinary sodium excretion the amount. Results After treatment with spironolactone, the serum sodium level in the sodium-limiting group was significantly lower than that in the sodium-free diet group. However, there was no significant difference in the onset time and effective time between the two groups. 35 cases (89.7%) in the sodium-free diet group were effective, and 34 cases (87.2%) in the sodium-limited diet group were effective, the total effective rate was 88.5%. Conclusion Single spironolactone diuretic effect is satisfactory, good safety, dietary sodium limit does not enhance the diuretic effect, it is not recommended to limit sodium diet.