论文部分内容阅读
本文对安体舒通与安体舒通加速尿对肝硬化腹水病人的利尿效果进行了对照研究。两组各为15例,安体舒通治疗组12例腹水完全消退,无效3例;安体舒通加速尿组也是12例有效,但利尿效果较快。两组治疗有效病例都有显著排钠利尿作用,尿钾排泄也略有增加,对血钾、钠无明显影响,平均内生性肌酐清除率都有增加,血浆醛固酮浓度也继发性升高。安体舒通加速尿组无效3例,治疗前血浆醛固酮浓度明显增高,肌酐清除率(32.1±14.3ml/min)低而治疗后无增加,尿钠排泄亦不增加。本文资料提示肝硬化腹水治疗的利尿剂合理使用以安体舒通为首选,或加用小剂量速尿,治疗前后监测血浆醛固酮浓度、尿钠、钾排泄量、内生性肌酐清除率,以指导用药。
In this paper, spironolactone and spironolactone accelerated urinary cirrhosis in patients with diuretic effect of a controlled study. In both groups, 15 patients were treated with spironolactone, and 12 patients with spironolactone treatment regressed completely and 3 patients were ineffective. Spironolactone-accelerating urine group was also effective in 12 patients, but diuretic effect was faster. Effective treatment of both groups have significant side effects of natriuresis, urinary potassium excretion also increased slightly, no significant effect on serum potassium, sodium, the average endogenous creatinine clearance rate has increased, plasma aldosterone concentration also increased secondary. Spironolactone accelerated urine group 3 cases of ineffective, before treatment plasma aldosterone concentration was significantly increased creatinine clearance (32.1 ± 14.3ml / min) and no increase after treatment, urinary sodium excretion does not increase. The data suggest that the rational use of diuretics in the treatment of cirrhosis and ascites spironolactone is preferred, or plus a small dose of furosemide before and after treatment to monitor plasma aldosterone concentrations, urinary sodium and potassium excretion, creatinine clearance rate to guide Medication.