托伐普坦治疗顽固性心力衰竭中严重利尿剂抵抗疗效观察  

Observation of the effect of Tolvaptan on severe diuretic resistance in refractory heart failure

作　　者：马素霞[1] 毛懿[2] 梁岩[2] 杨艳敏[2] 

机构地区：[1]河南省商丘市第一人民医院心内科,476100 [2]北京阜外心血管病医院急诊科

出　　处：《中国现代医药杂志》2014年第7期54-56,共3页Modern Medicine Journal of China

摘　　要：目的：观察托伐普坦治疗顽固性心力衰竭中严重利尿剂抵抗的疗效。方法对经大剂量利尿剂（速尿大于200mg/d）治疗效果不佳，且不伴有严重低钠血症的顽固性心力衰竭患者3例给予托伐普坦15mg/d治疗，观察治疗后体重、尿量、血肌酐、肝功能、电解质的变化。结果治疗1d后体重平均减轻3.16kg；尿量平均增加5540ml；治疗3~5d后血肌酐指标2例降至正常，另外1例较前有轻度改善；肝功能、电解质无明显变化。结论托伐普坦能有效治疗严重利尿剂抵抗，有助于心肾功能改善，疗效较好，无明显不良反应发生。Objective To observe the clinical effect of Tolvaptan on severe diuretic resistance in refractory heart failure. Methods 3 cases of patient with refractory heart failure and without severe hyponatremia had no good curative effect after large dose of diuretics （the dose of furosemide was more than 200mg/d） therapy, were treated with Tolvaptan （15mg/d）. The changes of body weight, urine volume, serum creatinine, liver function, electrolytes were observed after treatment. Results One day after treatment,body weight reduced 3.16kg on average, urine output reached 5 540ml on average. In the 3~5 days after treatment, creatine level dropped to normal in 2 cases, another case showed a slight decreasing tendency. Hepatic function and electrolyte had no obvious change. Conclusion Tolvaptan is effective in treating severe diuretic resistance,and helpful to improve car-diac and renal function,the curative effect is good,and has no significant adverse events.

关 键 词：托伐普坦 利尿剂抵抗 顽固性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]