重症心力衰竭合并肾功能不全40例联合药物治疗的远期疗效  

Long Term Efficacy of Combined Medication in Treatment of 40 Patients with Severe Heart Failure Complicated with Renal Insufficiency

作　　者：段秀卿[1] 傅研[1] 朱宇清[1] 

机构地区：[1]首都医科大学附属北京同仁医院,进修医师北京100730

出　　处：《内科急危重症杂志》2002年第2期78-80,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的 :观察重症心力衰竭合并肾功能不全患者联合用药的远期疗效。方法 :对 4 0例重症心力衰竭合并肾功能不全的患者 ,根据个体差异逐渐调整地高辛、依那普利、美托洛尔、氢氯噻嗪、螺内酯的用药剂量 ,长期随访观察两年。结果 :对重症心力衰竭合并肾功能不全患者长期联合用药治疗 ,随访显示 ,心功能明显改善 (P <0 .0 0 1) ,未加重肾功能损害 (P >0 .0 5 ) ,病死率下降。结论 :重症心力衰竭合并肾功能不全的患者 ,长期联合用药治疗 ,并根据血清肌酐清除率及地高辛浓度调整用药剂量 ,可有效改善心功能 ,不加重肾功能损害 。Objective: To observe long term therapeutic effect of combined medication on patients with severe heart failure complicated with renal insufficiency. Methods: Forty patients with severe heart failure complicated with renal insufficiency was treated with digoxin, enalapril, betaloc, spironolactone, hydrochlorothiazide, the dose of each medicine was adjusted according to the varience of each individuals, and followed up for two years. Results: Cardiac function was significantly improved in patients who received combined medication ( P < 0.001 ), renal insufficiency was not aggravated ( P > 0.05 ), and the mortality reduced. Conclusion: Long term combined medication with adjusted doses according to creatinine clearance and serum digoxin level for treatment of severe heart failure patients complicated with renal insufficiency will effectively improve cardiac function and quality of life without aggravation of renal insufficiency.

关 键 词：重症心力衰竭 肾功能不全 联合用药 远期疗效 

分 类 号：R541.6[医药卫生—心血管疾病]