【摘要】 目的比较左西孟旦联合托拉塞米与单独应用托拉塞米对心外科ICU心肾综合征病人治疗效果的影响。方法心肾综合征病人360例,分成两组,联合治疗组124例,采用左西孟旦联合托拉塞米治疗;单纯治疗组236例,单纯采用托拉塞米治疗。比较两组病人经治疗1周后多巴胺使用剂量和体重变化、脑尿钠肽(brain nnatriuretic peptide,BNP)、左室射血分数、肌酐清除率、应用持续肾脏替代治疗情况、血气电解质、监护室停留时间、住院死亡率、消化道出血发生率、住院费用等指标。结果联合治疗组治疗1周后多巴胺使用剂量、BNP、监护室停留时间、住院死亡率、持续肾脏替代治疗使用率、消化道出血发生率较单纯治疗组下降(P<0.05);而联合治疗组左室射血分数、1周体重减轻数、肌酐清除率与单纯治疗组比较,明显升高(P<0.05);联合治疗组血气电解质、住院费用与单纯治疗组比较差异无统计学意义(P>0.05)。结论左西孟旦联合托拉塞米治疗促进心脏外科ICU心肾综合征病人恢复,且不增加治疗费用,在监测状态下也不增加病人电解质紊乱风险。更多还原

【Abstract】 Objective To analysis the different effect of the combination of levosimendan with torasemide and torasemide on patients with cardiorenal syndrome in cardiac intensive care unit by according a retrospective study. Methods 124 cases of patients with cardiorenal syndrome in cardiac intensive care were defined as the combined treatment group who was treated with the combination of levosimendan and torasemide,and 236 patients who were randomly selected to be treated by the simple torasemide at the same period were defined as simple treatment group. Compare the differences of general data of patients,the changes of dopamine dose and weight treatment after 1 week,changes of BNP,left ventricular ejection fraction,creatinine clearance,application of CRRT,blood gas electrolyte change,ICU stay time,inpatient mortality,incidence of gastrointestinal bleeding and hospitalization expenses between the two groups. Results The changes of dopamine dose and weight treatment after 1 week,changes of BNP,Mortality,ICU stays,application of CRRT,incidence of gastrointestinal bleeding in the combined treatment group was reduced more than simple treatment group( P < 0. 05),the left ventricular ejection fraction,weight loss of one week and creatinine clearance in the combined treatment group were higher than those in simple treatment group( P < 0. 05). The blood gas electrolyte change,hospitalization expenses in combined treatment group and the control group had no significant difference( P > 0. 05). Conclusion The combination of levosimendan and torasemide can enhance the heart and renal function in patients with cardiorenal syndrome in cardiac intensive care unit,the treatment costs and the disturbance risk of electrolyte wasn’t increased.更多还原