Clinical study on alprostadil combined with torasemide in the treatment of intractable heart failure / 中国医师进修杂志

ABSTRACT

Objective To observe the short-term effect of alprostadil combined with torasemide in the treatment of intractable heart failure.Methods Thirty cases of patients with intractable heart failure and ineffective in routine therapy were given alprostadil and torasemide treatment,with alprostadil 20 mg in 5％ glucose or 0.9％ sodium chloride solution 100 ml intravenous infusion once a day and torasemide 20-40 mg intravenous twice a day 3 days later torasemide dosage was adjusted according to the disease,and the remaining conventional anti-heart failure therapy unchanged.Course was one week.The blood pressure,body weight,urine output,creatinine,electrolytes,N-terminal pro-brain natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF) before and after treatment was observed.Results After treatment,clinical symptoms of dyspnea,edema,pulmonary rales,such as wet and dry significantly improved in all patients.During the course of the treatment,3 patients appeared mild hypokalemia,and potassium was promptly corrected.Body weight after treatment reduced compared with that before treatment [(63.8 ± 7.6) kg vs.(82.6 ± 10.7) kg],urine output increased after treatment compared with that before treatment [(2 328.3 ±367.8) ml/d vs.(568.7 ± 104.6) ml/d],and the differences were statistically significant (P ＜ 0.01).Systolic blood pressure,diastohc blood pressure difference was not statistically significant after treatment,compared with that before treatment (P ＞ 0.05).LVEF after treatment increased compared with that before treatment [(44.5 ± 8.3)％ vs.(31.9 ± 10.2)％],serum creatinine levels reduced [(97.8 ± 18.6) μmol/L vs.(143.8 ±21.7) μmol/L],and the difference was statistically significant (P＜ 0.05) ; NT-proBNP after treatment reduced compared with that before treatment [(567.4 ± 212.3) ng/L vs.(2 726.5 ± 525.3) ng/L],and the difference was statistically significant(P ＜ 0.01).Conclusion Alprostadil combined with torasemide treatment can quickly and effectively improve symptoms and help improve heart and kidney function in intractable heart failure,and has no significant adverse reactions.