托伐普坦与传统利尿剂对伴低钠血症肝硬化腹水的疗效比较  

Comparison Between Tolvaptan and Routine Diuretics in the Treatment of Cirrhotic Ascites with Hyponatremia

作　　者：韩鲸璟 孙长宇[1] 康艳楠 何佳倩 郑利民[2] HAN Jing-jing;SUN Chang-yu;KANG Yan-nan;HE Jia-qian;Zheng Li-min(Department of Infectious Diseases,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;School of Life Science,Sun Yat-Sen University,Guangzhou 510060,China)

机构地区：[1]郑州大学第一附属医院感染性疾病科,河南郑州450000 [2]中山大学生命科学学院,广东广州510060

出　　处：《河南医学研究》2020年第8期1356-1358,共3页Henan Medical Research

基　　金：国家科技重大专项(2018ZX10302-205)。

摘　　要：目的探讨托伐普坦与传统利尿剂对伴低钠血症肝硬化腹水患者的疗效差异。方法选取100例伴有低钠血症肝硬化腹水患者为研究对象,以随机数表法分为托伐普坦组和传统利尿剂组。托伐普坦组接受标准剂量托伐普坦治疗,每日15 mg,传统利尿剂组接受标准剂量传统利尿剂,呋塞米每日80 mg,螺内酯每日100 mg,连续观察2周。比较两组治疗前后血清电解质、腹围、腹水深度、体质量、血肌酐、血压变化。结果治疗后托伐普坦组血钠较传统利尿剂组升高,腹水深度及体质量均低于传统利尿剂组(均P<0.05)。两组患者治疗前后血压水平、血肌酐水平无明显变化,差异无统计学意义(均P>0.05)。结论托伐普坦可提高伴低钠血症肝硬化腹水患者血清钠浓度,且较传统利尿剂能明显降低患者体质量、腹水深度,同时对血肌酐及血压无明显影响。Objective To discuss the difference between tolvaptan and routine diuretics in the treatment of cirrhotic ascites with hyponatremia.Methods One hundred patients of cirrhotic ascites with hyponatremia were selected as subjects, which were randomly divided into tolvaptan group and routine diuretic group. The tolvaptan group was asked to take the tolvaptan(15 mg·d-1), while the routine diuretic group was asked to take routine diuretic, Aldosterone antagonist and loop diuretic(furosemide, 80 mg·d-1, spironolactone,100 mg·d-1). Patients in two groups were treated for two weeks. The level of serum electrolytes, abdominal circumference, ascites depth, body weight, renal function and blood pressure were inspected and compared.Results The level of blood sodium in tolvaptan group was higher than that of the routine diuretic group, the depth of ascites and body weight were lower than those of the routine diuretic group after treated(all P<0.05). The blood pressure, kidney function remains unchanged, there were no statistical difference(all P>0.05).Conclusion Tolvaptan can increase the concentration of serum sodium, reduce body weight and the depth of ascites compared to routine diuretic, without significant effect on liver function, serum creatinine and blood pressure.

关 键 词：肝硬化腹水 低钠血症 托伐普坦 传统利尿剂 

分 类 号：R575.2[医药卫生—消化系统]