小剂量托伐普坦对超高龄慢性心力衰竭患者的疗效及安全性评价  

A review on curative effect and safety of low-dose tolvaptan in super-elderly patients with chronic heart failure

作　　者：姚璐 陈艳梅 武云涛 田国祥[1] 张峰[1] Yao Lu;Chen Yanmei;Wu Yuntao;Tian Guoxiang;Zhang Feng(Forth Department of Geriatrics,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心干四科

出　　处：《中国循证心血管医学杂志》2019年第12期1517-1519,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨小剂量托伐普坦片治疗超高龄慢性心力衰竭患者的临床疗效及安全性。方法选择2017年2月至2018年11月于解放军总医院第七医学中心干四科住院的12例超高龄慢性心力衰竭患者,在常规治疗基础上加用小剂量托伐普坦片(7.5 mg/d)治疗,观察治疗第3 d、第7 d及第30 d时所有患者的血钠、血钾、肌酐、尿素氮、谷丙转氨酶、谷草转氨酶、尿酸、脑钠肽、24 h尿量、血压、心率的变化和不良反应情况。结果治疗后患者血钠水平较治疗前有所上升,BNP逐渐下降,尿量也逐渐增多,且在治疗后30 d内尿量仍可持续高于治疗前水平。治疗后患者的血压、心率与治疗前相比均有下降,差异有统计学意义(P<0.05)。所有患者的血钾水平、肝功能(谷丙转氨酶、谷草转氨酶)、肾功能(肌酐、尿素氮、尿酸)与治疗前相比均无显著变化(P>0.05)。在观察期间有1例患者出现口干症状,1例患者有尿频表现。结论小剂量托伐普坦片在治疗超高龄慢性心力衰竭患者时,可升高血钠水平、增加尿量,改善心功能,稳定血压、心率,且无明显不良反应,具有较好的临床疗效及安全性。Objective To discuss the curative effect and safety of low-dose tolvaptan in super-elderly patients with chronic heart failure(CHF).Methods The super-elderly patients with CHF(n=12)were chosen from the Forth Department of Geriatrics in Seventh Medical Center of Chinese PLA General Hospital from Feb.2017 to Nov.2018,and they were treated with low-dose tolvaptan(7.5 mg/d)on the base of routine treatment.The changes of serum sodium(Na),serum potassium(K),creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),aspertate aminotransferase(AST),uric acid(UA),B-type natriuretic peptide(BNP),24-h urinary volume,blood pressure(BP)and heart rate(HR)and incidence of adverse reactions were observed on the 3rd d,7th d and 30th d.Results After treatment,Na level increased,BNP decreased gradually and urinary volume increased gradually,and urinary volume kept above pre-treatment level after 30 d in all patients.BP and HR decreased after treatment compared with those before treatment in all patients(P<0.05).The level of K,liver function(ALT,AST)and kidney function(Cr,BUN,UA)had no significant changes after treatment compared with before(P>0.05).There was 1 patients with thirst symptom,and 1 with frequent urinary during observation period.Conclusion Lowdose tolvaptan can promote Na level and urinary volume,improve heart function and stabilize BP and HR,has no significant reverse reactions and has higher clinical efficacy and safety in super-elderly patients with CHF.

关 键 词：托伐普坦片 慢性心力衰竭 超高龄 

分 类 号：R541.61[医药卫生—心血管疾病]