ABSTRACT
Objective: To observe therapeutic effect of torasemide combined small dose dopamine on patients with refractory heart failure (RHF). Methods: A total of 146 RHF patients, who were treated in our hospital from Jan 2015 to Sep 2016, were selected. According to random number table, they were randomly and equally divided into torasemide group and combined treatment group (received torasemide combined small dose dopamine), both groups were treated for 7d. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), 6min walking distance (6MWD), levels of interleukin 6 (IL-6) and tumor necrosis factorα (TNF-α) before and after treatment, and total effective rate were measured and compared between two groups. Results: Compared with before treatment, after treatment, there were significant rise in LVEF and 6 MWD, and significant reductions in LVEDd, levels of IL-6 and TNF-αin two groups, P=0. 001 all; compared with torasemide group after 7d treatment, there were significant rise in LVEF [(30. 69±4. 52) ％ vs. (36. 29±4. 86) ％]and 6MWD [(271. 21±48. 32) m vs. (322. 45±56. 34) m], and significant reductions in LVEDd [(54. 17±7. 64) mm vs. (46. 52±6. 52) mm], levels of IL-6 [(34. 65±6. 13) μg/ml vs. (26. 18±4. 53) μg/ml]and TNF-α [(50. 27±8. 74) μg/ml vs. (37. 48± 7. 04) μg/ml]in combined treatment group, P=0. 001 all. Total effective rate of combined treatment group was significantly higher than that of torasemide group (90. 4％ vs. 71. 2％, P=0. 03). Conclusion: Torasemide combined small dose dopamine can significantly reduce levels of IL-6 and TNF-α, improve cardiac function and therapeutic effect in RHF patients, which is worth extending.
ABSTRACT
<p><b>BACKGROUND</b>Tumor necrosis factor-α is a key mediator in the pathogenesis of psoriasis. Infliximab is a monoclonal antibody that specifically binds to tumor necrosis factor-α. The purpose of this study was to validate the efficacy and safety of 5 mg/kg infliximab therapy in Chinese patients with moderate to severe plaque psoriasis.</p><p><b>METHODS</b>In this multicenter, double-blind, placebo-controlled trial, 129 patients with moderate-to-severe psoriasis were randomized to the induction therapy (weeks 0, 2 and 6) with infliximab 5 mg/kg (n = 84) or placebo (n = 45), followed with infliximab 5 mg/kg scheduled at week 14 and week 22 in the infliximab group, and infliximab 5 mg/kg scheduled at weeks 10, 12 and 16 in the placebo group. The primary end point was the proportion of patients who achieved at least 75% improvement in Psoriasis Area and Severity Index (PASI 75 response rate) from baseline at week 10.</p><p><b>RESULTS</b>At week 10, 81.0% of patients treated with infliximab (5 mg/kg) achieved a 75% or greater improvement compared with 2.2% of patients treated with placebo (P < 0.001). A significant improvement in PASI, Physician's Global Assessment (PGA) and Dermatology Life Quality Index (DLQI), was seen from week 6 through week 14 in the infliximab group compared with the placebo group. Through week 22, PASI, PGA, DLQI were well maintained. The incidence of adverse events for the infliximab treatment group was slightly higher in comparison to the placebo treatment group during the first 10 weeks without statistical significance. However, there were 3 cases of tuberculosis that developed during the 26 weeks treatment with infliximal.</p><p><b>CONCLUSIONS</b>Infliximab treatment was effective as induction and maintenance treatments for Chinese patients with moderate to severe plaque psoriasis. Most drug-induced adverse events were mild to moderate, and well tolerated. Screening for tuberculosis is essential and prophylactic treatment should be given if necessary.</p>