TORASEMID PROLONGIROVANNOGO DEYSTVIYa U PATsIENTOV S OTEChNO-ASTsITIChESKIM SINDROMOM


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Abstract

Torasemide is an alternative to conventional diuretics in the treatment of edematous-ascitic syndrome, the most common complication of hepatic cirrhosis. In recent years, a sustained-release torasemide (3B) appeared. Prolonged form (britomar), having all the properties of torasemide, provides a gradual release of the drug, which reduces fluctuations of the torasemide concentration in the blood plasma. The study was aimed to the evaluation of the efficacy and safety of torasemide 3B (britomar) in 42 patients with edematous-ascitic syndrome on the background of cirrhosis decompensation. All patients followed a diet with restriction of salt about 3 g/day, abstained from alcohol and received standard therapy for hepatic cirrhosis: transfusions of albumin and fresh frozen plasma, lactulose, ciprofloxacin, propranolol. The main group received torasemide 3B (n=20), the control group - furosemide (n=22). All patients received spironolactone. Drugs were taken orally in tablet form, for an average of 3 weeks. Initial doses of diuretic (torasemide 3B 10 mg, furosemide 40 mg, spironolactone 100 mg/day) were 2-fold increased every 3 days in the case of body weight loss less than 300 g/d. Against the background of diuretic therapy, both groups showed a decrease in edema syndrome: pastosity of legs and feet remained in 2 (10%) patients in torasemide 3B group; and in 6 (27%) patients in furosemide group. All patients had regression of ascites until I degree. More pronounced diuretic effect was observed in the torasemide 3B group. In the torasemide 3B group diuresis increased by an ave-rage of 865±660 ml, in the furosemide group - by 400±300 mL (p=0.018). Thus, comparison of furosemide and torasemide 3B in the study group indicates significantly greater diuretic and saluretic action. Statistically significant difference in weight loss and regression of edematous syndrome, however, have not been identified.

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References

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