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中文摘要：
目的 评价强化利尿治疗慢性心力衰竭（CHF）急性失代偿期的有效性、安全性及其对患者住院天数和费用的影响.方法 回顾性分析2006年1月1日至2007年9月1日福建医科大学附属协和医院心内科诊断为CHF心功能Ⅲ～Ⅳ级患者的临床资料.以入院后第2日的24 h尿量为标准分为≥2 400 ml组（强化利尿组）和〈2 400 ml组（非强化利尿组）两组,观察强化利尿前后生化指标和生命体征的变化,比较两组住院期间的病死率和住院天数、费用的差异.结果 共195例患者入选,其中强化利尿组73例,非强化利尿组122例.强化利尿组住院期间的病死率低于非强化利尿组（1.4%比9.8%,P〈0.05）,住院天数、总费用和平均费用的中位数均低于非强化利尿组[住院天数：11 d比16 d;总费用：8 483元比12 182元;平均费用I：721.1元/日比854.4元/日;平均费用Ⅱ（不包括检查费）：580.0元/日比698.2元/日,P〈0.05或P〈0.013.强化利尿治疗前后生化指标和心率变化差异无统计学意义;但强化利尿后的收缩压和舒张压均低于入院时水平[收缩压：（118.2±16.9）mm Hg比（127.0±24.9）mm Hg;舒张压：（67.2±4.5）mm Hg比（75.2±4.9）mm Hg,1 mm Hg=0.133 kPa.P〈0.05和P〈0.013.所有患者均未出现头晕、胸闷等低血压症状.结论 强化利尿治疗对CHF急性失代偿期患者安全有效,可减少患者住院天数和费用以及住院病死率.
英文摘要：
Objective To evaluate both the efficacy,safety,length of stay in hospital and expenses of aggressive diuretic therapy in patients with acute decompensation of chronic heart failure（CHF）.Methods The retrospective analysis was conducted in the patients with acute decompensation CHF New York Heart Association （NYHA） class Ⅲ or Ⅳ in department of cardiology of Fujian Medieal University Union Hospital from January 1st 2006 to September 1st 2007.The 24-hour urine volume on the 2nd day was equivalent or over 2 400 ml was defined as aggressive diuretic therapy group,and those with less than 2 400 ml of urine as non-aggressive diuretic therapy group.The biochemical parameters and vital signs were compared before and after aggressive diuretic therapy,and the mortality,the length of stay and expenses were also compared between the two groups.Results One hundred and ninety-five patients were enrolled in the study,there were 73 and 1 22 patients in aggressive diuretic therapy group and in non-aggressive diuretic therapy group respectively.The mortality in aggressive diuretic therapy group was lower than that in non-aggressive diuretic therapy group（1.4%vs.9.8%,P〈0.05）.The length of stay,total expenses and average cost in aggressive diuretic therapy group were lower than those in non-aggressive diuretic therapy group r espectively [the length of stay：11 days vs.16 days;total expenses：8 483 yuan vs.12 182 yuan;average expense I：721.1 yuan/d vs.854.4 yuan/d;average expense Ⅱ （except for examination expenses）：580.0 yuan/d vs.698.2 yuan/d,P〈0.05 or P〈0.01].There were no significant changes in biochemical parameters and heart rate before and after aggressive diuretic therapy.The systolic pressure （SBP） a nd diastolic pressure （DBP） were reduced significantly after aggressive diuretic therapy[SBP：（118.2±16.9）mm Hg vs.（127.0±24.9）mm Hg;DBP：（67.2±4.5）mm Hg vs.（75.2±4.9）mm Hg,1 mm Hg=0.133 kPa,P〈0.05 and P〈0.01].No hypotension symptoms such as dizziness and chest d
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