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发表于 2003-7-30 03:50
J Hepatol. 2003 Aug;39(2):187-92. Links
Spironolactone alone or in combination with furosemide in the treatment of
moderate ascites in nonazotemic cirrhosis. A randomized comparative study of
efficacy and safety.
Santos J, Planas R, Pardo A, Durandez R, Cabre E, Morillas RM, Granada ML,
Jimenez JA, Quintero E, Gassull MA.
Department of Gastroenterology, Hospital Universitari Germans Tri;as i
Pujol, Carretera del Canyet, s/n, 08916, Badalona, Spain
BACKGROUND/AIMS: The most rational treatment of moderate ascites is
spironolactone alone or in combination with furosemide. However, it is
unknown which of these two treatment schedules is preferable.METHODS: One
hundred nonazotemic cirrhotic patients with moderate ascites were randomly
assigned to be treated with spironolactone and furosemide (Group 1: 50
patients) or with spironolactone alone (Group 2: 50 patients). If no
response was obtained, the doses of diuretics were increased up to 400
mg/day of spironolactone and 160 mg/day of furosemide. In patients of group
2 not responding to 400 mg/day of spironolactone, furosemide was added. In
cases with an excessive response, the dosage of diuretics was
reduced.RESULTS: The response rate (98% in Group 1 vs. 94% in Group 2), the
rapidity of ascites mobilization and the incidence of complications induced
by diuretic therapy was similar in both groups. The need to reduce the
diuretic dosage was significantly higher in Group 1 than Group 2 (68% vs.
34%; P=0.002).CONCLUSIONS: In the treatment of moderate ascites,
spironolactone alone seems to be as safe and effective as spironolactone
associated with furosemide. Since spironolactone alone requires less dose
adjustment, it would be more suitable for treating ascites on an outpatient
basis.
PMID: 12873814 [PubMed - in process]
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