{"id":7677,"date":"2014-07-08T10:05:04","date_gmt":"2014-07-08T10:05:04","guid":{"rendered":""},"modified":"2014-07-08T10:05:04","modified_gmt":"2014-07-08T10:05:04","slug":"torazemidas-diuretikas-kuri-verta-rinktis-letiniu-sirdies-nepakankamumu-sergantiems-pacientams","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/torazemidas-diuretikas-kuri-verta-rinktis-letiniu-sirdies-nepakankamumu-sergantiems-pacientams\/7677\/","title":{"rendered":"Torazemidas \u2013 diuretikas, kur\u012f verta rinktis l\u0117tiniu \u0161irdies nepakankamumu sergantiems pacientams"},"content":{"rendered":"

\u00a0\u012evadas <\/strong><\/p>\n

I\u0161sivys\u010diusiose \u0161alyse net 1\u20132 proc. suaugusi\u0173\u00adj\u0173 populiacijos serga l\u0117tiniu \u0161irdies nepakankamu\u00admu (L\u0160N), o per 70 met\u0173 asmen\u0173 sergamumas vir\u00ad\u0161ija 10 proc. (1). Da\u017eniausia L\u0160N prie\u017eastis \u2013 i\u0161e\u00admin\u0117 \u0161irdies liga (I\u0160L), ta\u010diau ne ma\u017eiau svarbios hipertenzija, kardiomiopatijos, \u0161irdies vo\u017etuv\u0173 ligos, aritmijos, miokarditai, toksini\u0173 med\u017eiag\u0173 poveikis, chemoterapija, kai kurios genetin\u0117s prie\u017eastys (2). L\u0160N lemia gyvenimo kokyb\u0117s blog\u0117jim\u0105, funkcinio paj\u0117gumo ma\u017e\u0117jim\u0105, o dekompensacijos epizodai \u2013 hospitalizavim\u0105. Tai susij\u0119 su didel\u0117mis sveikatos apsaugos i\u0161laidomis ir padid\u0117jusia mir\u0161tamumo ri\u00adzika, mirtis da\u017eniausiai i\u0161tinka d\u0117l \u0161irdies siurblio nepakankamumo ar skilvelini\u0173 aritmij\u0173.<\/p>\n

Kilpiniai diuretikai yra L\u0160N simptominio gydy\u00admo pagrindas. Jie greitai ir reik\u0161mingai suma\u017eina L\u0160N simptomus, pagerina paciento fizinio kr\u016bvio toleravim\u0105. Da\u017eniausiai klinikin\u0117je praktikoje ski\u00adriami kilpiniai diuretikai yra furozemidas ir toraze\u00admidas. Jie abu priklauso tai pa\u010diai grupei, ta\u010diau esa\u00adma svari\u0173 j\u0173 farmakologinio poveikio skirtum\u0173. Ke\u00adliuose tyrimuose analizuota, ar geresn\u0117s torazemido farmakokinetin\u0117s savyb\u0117s, palyginti su furozemidu, lemia geresnes pacient\u0173 klinikines i\u0161eitis. Nustatyta, kad torazemidas, palyginti su furozemidu, suma\u017ei\u00adna tiek su L\u0160N susijusi\u0173 hospitalizacij\u0173 da\u017en\u012f, tiek ir j\u0173 trukm\u0119, o tyrimas TORIC (angl. The Toraze\u00admide in Congestive Heart Failure) parod\u0117, kad to\u00adrazemidas ne tik suma\u017eina L\u0160N sergan\u010di\u0173 pacient\u0173 NYHA funkcin\u0119 klas\u0119, bet ir 51,5 proc. suma\u017eina \u0161i\u0173 pacient\u0173 mir\u0161tamum\u0105, palyginti su furozemidu ar kitu diuretiku (3).<\/p>\n

Taigi farmakologiniai furozemido ir torazemido skirtumai turi reik\u0161mingos \u012ftakos klinikiniams gy\u00addymo rezultatams, tai i\u0161kelia torazemid\u0105 \u012f lyderio pozicij\u0105 gydant L\u0160N.<\/p>\n

\u00a0<\/p>\n

\u0160irdies nepakankamumo klinika <\/strong><\/p>\n

Pirmin\u0117s stadijos L\u0160N sunku diagnozuoti, nes liga turi daug simptom\u0173, kuri\u0173 vieni labai specifi\u00adniai, kiti \u2013 ma\u017eiau (1 lentel\u0117<\/em>), bet sergant lengvu L\u0160N, specifi\u0161kesni\u0173 simptom\u0173 (dusulys<\/a>, paroksiz\u00adminis naktinis dusulys<\/a>) pasitaiko re\u010diau (4\u20138). Dau\u00adguma simptom\u0173 susij\u0119 su drusk\u0173 ir vandens susilai\u00adkymu, tod\u0117l n\u0117ra specifiniai, periferin\u0117s edemos \u2013 taip pat. Sunkiau nustatyti specifi\u0161kesnius simpto\u00admus, pavyzd\u017eiui, padid\u0117jus\u012f jungo ven\u0173 spaudim\u0105.<\/p>\n

\n","protected":false},"excerpt":{"rendered":"

I\u0161sivys\u010diusiose \u0161alyse net 1\u20132 proc. suaugusi\u0173\u00adj\u0173 populiacijos serga l\u0117tiniu \u0161irdies nepakankamu\u00admu (L\u0160N), o per 70 met\u0173 asmen\u0173 sergamumas vir\u00ad\u0161ija 10 proc. (1). Da\u017eniausia L\u0160N prie\u017eastis \u2013 i\u0161e\u00admin\u0117 \u0161irdies liga (I\u0160L), ta\u010diau ne ma\u017eiau svarbios hipertenzija, kardiomiopatijos, \u0161irdies vo\u017etuv\u0173 ligos, aritmijos, miokarditai, toksini\u0173 med\u017eiag\u0173 poveikis, chemoterapija, kai kurios genetin\u0117s prie\u017eastys (2). L\u0160N lemia gyvenimo kokyb\u0117s blog\u0117jim\u0105, funkcinio paj\u0117gumo ma\u017e\u0117jim\u0105, o dekompensacijos epizodai \u2013 hospitalizavim\u0105. Tai susij\u0119 su didel\u0117mis sveikatos apsaugos i\u0161laidomis ir padid\u0117jusia mir\u0161tamumo ri\u00adzika, mirtis da\u017eniausiai i\u0161tinka d\u0117l \u0161irdies siurblio nepakankamumo ar skilvelini\u0173 aritmij\u0173.<\/p>\n","protected":false},"author":1,"featured_media":7678,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[3731,1296,797,3732,772,747,54,896,3783,1198,138],"site":[],"post_item_type":[27345],"class_list":["post-7677","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gydymo-naujienos","tag-diuretikams","tag-dusulys","tag-eliminacijos","tag-furozemido-grupeje","tag-grupeje-proc","tag-klinikinis","tag-rezimo","tag-slapinimasis","tag-torazemidas","tag-uminis","tag-vaistai"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/7677","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=7677"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/7677\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media\/7678"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=7677"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=7677"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=7677"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=7677"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=7677"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}