利尿药物联合威利坦治疗高龄慢性心力衰竭患者下肢水肿的临床分析  

Clinical Analysis on the Efficacy of Diuretic Combined with Venostan for Treatment of Lower Extremity Edema in Elder Patients with Chronic Longestive Heart Failure

作　　者：卞宁[1] 

机构地区：[1]海军总医院干部心内科,北京100048

出　　处：《医学综述》2013年第23期4358-4360,共3页Medical Recapitulate

摘　　要：目的 研究与分析利尿药物联合马栗种子提取物片（威利坦）治疗高龄慢性心力衰竭（心衰）患者下肢水肿的临床疗效.方法 选取2011年1月至2011年12月在海军总医院干部心内科住院治疗的慢性心衰患者30例,单用利尿剂（呋塞米20 ～40 mg/d逐渐加量）治疗2周,联合应用威利坦（每次2片,每日2次）治疗2周,并同时给予利尿药物原有剂量减半,直至最小维持量;观察临床疗效.结果 患者在治疗前,治疗1周、2周、3周、4周时小腿的周径呈现进行性减小,差异有统计学意义（P＜0.05）.患者在治疗1周、2周时的肾功能和电解质较用药前出现了进行性的改变,电解质紊乱的改善尤为明显,治疗3周、4周时肾功能减退及电解质紊乱情况得到纠正,且紊乱程度减轻,血肌酐、血尿酸浓度随时间变化差异有统计学意义（P＜0.05）.与非糖尿病患者相比,在合并糖尿病的患者中小腿的周径减小更为显著,其在组间及不同时间点差异有统计学意义（P＜0.05）.结论 在利尿剂的基础上联合应用威利坦口服可明显改善高龄心衰患者的下肢水肿,并能减少利尿药物带来的肾功能及尿酸的异常改变.其中,在合并糖尿病的患者中效果更为显著.Objective To study and analyze the efficacy of diuretic combined with venostan on lower extremity edema in eider patients with chronic heart failure. Methods From Jan. 2011 to Dec. 2011,30 patients with chronic heart failure from Cadres Cardiology Department of Navy General Hospital were enrolled in the trial ,and were given only diuretic （furosemide tablets 20-40mg/d, gradually increased ）orally for 2 weeks, and then venostan tablets were added orally twice a day for 2 weeks, while the diuretic was reduced to half dosage till the minimum dosage; the clinical efficacy was observed during the treatment. Results Calf circumference showed progressive decreases of the patients before treatment, 1 week ,2 weeks,3 weeks, and 4 weeks after treatment, with statisticallydifference（ P 〈 O. 05 ）. Renal function and electrolytes 1 week ,2 weeks after therapy showed a progressive change, especially the electrolyte disorders, kidney function and electrolyte disorder situation were corrected 3 weeks and 4 weeks after treatment, and especially obvious in electrolyte disorder. Serum creatinine, blood uric acid concentration changed along with the time with statistically signifi- cant difference （P 〈 O. 05 ）. Compared with patients without diabetes calf diameter decreased more obviously in patients with diabetes mellitus, the differences between groups and different time points were statistically significant（ P 〈 O. 05 ）. Conclusion Venostan oral tablets on the basis of diuretics can alleviate lower extremity edema of the elder patients with chronic heart failure and alleviate the damage to kidney function and uric acid changes. The efficacy is better in patients with diabetes too.

关 键 词：利尿药物 威利坦 高龄心力衰竭 下肢水肿 

分 类 号：R541.6[医药卫生—心血管疾病]