托伐普坦与托拉塞米治疗重症心力衰竭伴稀释性低钠血症效果比较  

Comparison of the effects of tolvaptan and torasemide in the treatment of severe heart failure with dilute hyponatremia

作　　者：倪金波[1] NI Jinbo(The Fifth Division Hospital of Xinjiang Production and Construction Corps,Xinjiang Province,Bole 833400,China)

机构地区：[1]新疆生产建设兵团第五师医院,新疆博乐市833400

出　　处：《临床合理用药杂志》2020年第17期7-8,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的比较托伐普坦、托拉塞米治疗重症心力衰竭伴稀释性低钠血症的临床效果。方法选取2017年5月-2018年5月新疆生产建设兵团第五师医院收治的重症心力衰竭伴稀释性低钠血症患者100例为研究对象,采取随机数字表法分为观察组和对照组,每组50例。2组均给予常规治疗,在此基础上,观察组给予托伐普坦治疗,对照组给予托拉塞米治疗。比较2组治疗后超声心动图参数[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、舒张晚期峰值速度比值(E/A)]、血液指标(脑钠肽、24 h尿量、血钠、血钾)、治疗效果。结果治疗后,观察组LVEF、LVEDD、LVESD、E/A均优于对照组(P<0.01);观察组脑钠肽、24 h尿量、血钠、血钾水平均优于对照组(P<0.01);观察组总有效率为98.00%,高于对照组的70.00%(χ^2=14.583,P<0.01)。结论托伐普坦治疗重症心力衰竭伴稀释性低钠血症患者效果更好,值得临床推广应用。Objective Compare the clinical effects of tolvaptan and torasemide in the treatment of severe heart failure with dilute hyponatremia. Methods 100 patients with severe heart failure and dilute hyponatremia admitted to the Fifth Division Hospital of Xinjiang Production and Construction Corps from May 2017 to May 2018 were selected as the research subjects. The patients were randomly divided into observation group and control group with 50 cases in each group. Both groups were given routine treatment,on this basis,the observation group was treated with tolvaptan,while the control group was treated with torasemide. Comparison of echocardiographic parameters after treatment[left ventricular ejection fraction( LVEF),left ventricular end-diastolic diameter( LVEDD),left ventricular end-systolic diameter( LVESD),late diastolic peak velocity ratio( E/A) ],blood Indicators( brain natriuretic peptide,24 h urine volume,blood sodium,blood potassium),treatment effect.Results After treatment,LVEF,LVEDD,LVESD and E/A in the observation group were all better than those in the control group( P < 0. 01);The total effective rate of the observation group was 98. 00%,higher than that of the control group( χ2=14. 583,P < 0. 01). Conclusion Tolvaptan is more effective in the treatment of severe heart failure with dilute hyponatremia,and ti is worthy of clinical promotion.

关 键 词：重症心力衰竭 稀释性低钠血症 托伐普坦 托拉塞米 临床效果 

分 类 号：R541.6[医药卫生—心血管疾病] R591.1[医药卫生—内科学]