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复方高渗盐溶液对失代偿性心力衰竭的影响

Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure.

作者信息

Wan Yanfang, Li Lei, Niu Heping, Ma Xiaoli, Yang Jing, Yuan Chen, Mu Guichen, Zhang Jun

机构信息

Department of Cardiology, Cangzhou Central Hospital, Hebei Medical University.

出版信息

Int Heart J. 2017 Aug 3;58(4):601-607. doi: 10.1536/ihj.16-313. Epub 2017 Jul 13.

Abstract

The aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF.

摘要

本研究的目的是评估高剂量呋塞米联合高渗盐溶液(C-HSS)对纽约心脏协会(NYHA)III级心力衰竭患者住院时间、再入院率和死亡率的影响。将患有慢性缺血性或非缺血性心肌病且射血分数<40%的失代偿性心力衰竭患者(NYHA III级)以开放标签随机方式分为两组:第一组每天接受两次1小时静脉输注呋塞米(100mg)加复方C-HSS(100mL),并严格限制水分摄入(500mL/天);第二组每天接受两次呋塞米静脉推注(100mg)和水分限制(500mL/天),不使用C-HSS。两组钠摄入量均正常(120mmol钠)。出院后,两组继续接受每天120mmol钠和500-1000mL水的摄入。与第二组(132例未使用C-HSS患者)相比,第一组(132例C-HSS患者)尿量增加,住院时间缩短(4±2天对7±2天,P<0.01),住院费用降低(2210元对3506元,P<0.01)。在随访期(36±12个月)内,第一组平均再入院时间显著更长(31.84±7.58个月对15.60±6.25个月,P<0.01),死亡率更低(16.5%对31.9%,P<0.01)。结果表明,定期给予C-HSS,联合严格的水分限制和正常的钠饮食,可显著降低NYHA III级心力衰竭患者的住院时间、再入院率和死亡率。

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