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目的比较托拉塞米和丹参酮ⅡA磺酸钠治疗慢性充血性心力衰竭的临床疗效。方法选取2014年1月—2015年12月在邢台市第三医院治疗的慢性充血性心力衰竭患者78例,随机分为对照组和治疗组,每组各39例。对照组静脉注射丹参酮ⅡA磺酸钠注射液,20 mg/次,1次/d。治疗组静脉注射托拉塞米注射液,20 mg/次,1次/d。两组均连续治疗7 d。观察两组的临床疗效,比较两组B型脑钠肽(BNP)、血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)和左心室肥厚指标。结果治疗后,对照组和治疗组的总有效率分别为69.2%、87.2%,两组比较差异有统计学意义(P<0.05)。治疗后,两组BNP、PRA、AngⅡ和ALD水平均有明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左室后壁舒张末期厚度(LVPWT)、左室舒张末期内径(LVDD)和室间隔舒张末期厚度(IVST)均有明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论托拉塞米治疗慢性充血性心力衰竭的临床疗效优于丹参酮ⅡA磺酸钠,能降低血浆BNP、PRA、AngⅡ和ALD水平,改善左心室肥厚,安全性较好,具有一定的临床推广应用价值。
Objective To compare the clinical efficacy of torsemide and tanshinone Ⅱ A sulfonate in the treatment of chronic congestive heart failure. Methods From January 2014 to December 2015, 78 patients with chronic congestive heart failure treated in the Third Hospital of Xingtai City were randomly divided into control group and treatment group, 39 cases in each group. Control group intravenous injection of tanshinone Ⅱ A sodium sulfonate, 20 mg / time, 1 time / d. Treatment group intravenous injection of torsemide injection, 20 mg / time, 1 time / d. Two groups were treated for 7 days. The clinical efficacy of the two groups was observed. The levels of B-type natriuretic peptide (BNP), plasma renin (PRA), angiotensin II (AngⅡ), aldosterone (ALD) and left ventricular hypertrophy were compared. Results After treatment, the total effective rates of the control group and the treatment group were 69.2% and 87.2%, respectively, with significant difference between the two groups (P <0.05). After treatment, the levels of BNP, PRA, AngⅡ and ALD in both groups were significantly decreased, with statistical significance (P <0.05) before and after treatment in the same group; and the decline of these indexes in the treatment group was obviously better than that in the control group The difference was statistically significant (P <0.05). After treatment, LVPWT, LVDD and IVST of the two groups were significantly decreased (P <0.01), and there was significant difference between the two groups before and after treatment (P < 0.05). The decline of these observation indexes in the treatment group was obviously better than that in the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Torasemide treatment of chronic congestive heart failure is better than tanshinone Ⅱ A sodium sulfonate, can reduce plasma BNP, PRA, Ang Ⅱ and ALD levels, improve left ventricular hypertrophy, safety is good, with a certain clinical application value.