阿佐塞米治疗心、肝、肾等疾患引起的水肿或腹水的临床疗效和安全性  

Efficacy and safety of azosemide in patients with edema and ascites

作　　者：张芸[1] 胡晓晟[1] 陈君柱[1] 吴宗贵[2] 黄高忠[2] 黄永麟[3] 林维勤[1] 郑经川[1] 

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003 [2]上海长征医院,上海200333 [3]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001

出　　处：《浙江大学学报（医学版）》2005年第5期459-464,共6页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的:研究髓袢利尿剂阿佐塞米治疗心、肝、肾等疾患引起水肿或腹水的临床疗效和安全性.方法:采用随机、盲法、多中心、呋塞米对照方法,将223例符合入选标准的患者(心性水肿92例、肝性水肿63例、肾性水肿68例)随机分入阿佐塞米组和呋塞米组,心性和肾性水肿患者每日一次口服阿佐塞米30 mg或呋塞米20 mg,肝性腹水患者每日一次口服阿佐塞米60 mg或呋塞米40 mg.3日末如利尿未达有效者药物剂量增加,心性和肾性水肿患者至阿佐塞米60 mg或呋塞米40 mg,肝性腹水患者阿佐塞米每日90 mg或呋塞米每日60 mg,直至2周末.结果:2周末,阿佐塞米、呋塞米组体重均较治疗前显著下降,体重下降(2.87±3.10)kg和(2.81±2.84)kg;消肿有效率为89.19%和89.81%;纠正心功能不全有效率为64.44%和66.66%;24 h尿量增加(321.85±669.52)ml和(273.80±645.72)ml;B超测定治疗腹水有效率为89.28%和86.66%;腹围减少(5.20±3.58)cm和(5.03±3.74)cm.两组间比较无统计学差异(P>0.05).两组不良反应发生率分别为23.01%和21.01%,主要表现为低血钾、血尿酸升高、甘油三酯升高、口干和ALT升高等.结论:阿佐塞米片30～90 mg每日一次口服治疗2周,疗效及安全性与20～60 mg呋塞米片一致;对心、肝、肾性水肿或腹水有显著的消肿利尿、改善心功能、减少腹水的作用,是一种有效、耐受性良好的治疗药物.Objective： To assess the efficacy and safety of azosemide in patients with edema and ascites. Methods： A multicentral, randomized,double-blind,controlled clinical trial was applied. All 223 patients （cardiac edema 92,hepatogenic edema 63,renal edema 68） were randomized to azoesmide and furosemide group,and all patients were treated for 2 weeks. Patients with cardiac or renal edema took azosemide （30 mg/d） or furosemide （20 mg/d）; patients with hepatogenic edema took azosemide （60 mg/d） or furosemide （40 mg/d）, The dosage were adjusted to azosemide 60 mg/d （cardiac, renal edema）, 90 mg （hepatogeic edema）; or furosemide 40 mg/d （cardiac,renal edema）, 60 mg （hepatogeic edema）,if diuretic effects were not obtained at the end of third day. Results：At the end of the study, the weight changes were （2.87±3,10）kg and （2,81±2.84）kg; the total effective rate of edema lessen was 89.19± and 89, 81% ; the total effective rate of heart function improvement was 64,44% and 66,66%; the 24 h urine output increased （321,85± 669,52）ml and （273,80± 645.72）ml for azosemide and furosemide,respectively, The total effective rate of ascites lessen （tested by B-ultrasound） was 89.28% and 86, 66% ; abdominal girth decreased （5.20± 3, 58） cm and （5.03 ± 3, 74） cm for azosemide and furosemide, respectively, The adverse event rate was 23.01% in azosemide group and 21, 01% in furosemide group; the main adverse effects were hypokalemia ,hyperuricemia ,hypertriglyceridemia and thirsty. Conclusion： Azosemide could effectively lessen edema,improve heart function and decrease ascites; it is well tolerated and is particularly useful for the diuretic treatment.

关 键 词：阿佐塞米/投药和剂量 呋塞米/投药和剂量 水肿/药物疗法 腹水/药物疗法 随机对照试验 

分 类 号：R96[医药卫生—药理学]