托伐普坦治疗肝硬化顽固性腹水合并低钠血症的疗效  

Clinical efficacy of tolavtan in the treatment of cirrhosis complicated with refractory ascites and hyponatremia

作　　者：于明芳 YU Ming-fang(Dalian Sixth People’s Hospital,Dalian 116031,China)

机构地区：[1]大连市第六人民医院肝九病房,116031

出　　处：《中国实用医药》2021年第17期15-17,共3页China Practical Medicine

摘　　要：目的评价托伐普坦治疗肝硬化顽固性腹水合并低钠血症的临床疗效。方法62例肝硬化顽固性腹水合并低钠血症患者,按照治疗方法不同分为常规治疗组(32例)和联合治疗组(30例)。常规治疗组患者给予常规治疗,联合治疗组患者在常规治疗基础上联合托伐普坦治疗。比较两组患者治疗前及治疗后第1、3、7天24 h尿量、血钠水平,治疗前及治疗后第7天肾功能指标[尿素氮(BUN)、肌酐(Crea)]。结果治疗后第1、3、7天,联合治疗组患者24 h尿量较本组治疗前明显增加,且联合治疗组患者24 h尿量(3618±1618)、(2618±1628)、(2390±950)ml明显多于常规治疗组的(1416±605)、(1474±625)、(1567±693)ml,差异有统计学意义(P<0.05)。治疗后第1、3、7天,联合治疗组患者血钠水平较本组治疗前明显升高,且联合治疗组患者血钠水平(132.4±6.3)、(133.4±6.9)、(134.0±6.8)mmol/L明显高于常规治疗组的(128.7±6.4)、(128.4±6.6)、(129.5±6.7)mmol/L,差异有统计学意义(P<0.05)。治疗后第7天,两组患者BUN、Crea较治疗前无明显变化,组内及组间比较差异均无统计学意义(P>0.05)。结论联合应用托伐普坦对肝硬化顽固性腹水合并低钠血症利尿作用显著,同时可提升血钠水平,短期使用对肾脏功能无影响。Objective To evaluate the clinical efficacy of tolavtan in the treatment of cirrhosis complicated with refractory ascites and hyponatremia.Methods A total of 62 cases of cirrhosis complicated with refractory ascites and hyponatremia were divided into conventional treatment group(32 cases)and combined treatment group(30 cases).The conventional group was treated with conventional therapy,and the combined group was treated with tolavtan on the basis of conventional therapy.The 24 h urine output and blood sodium level before treatment and after 1,3,7 days of treatment,and renal function indicators[urea nitrogen(BUN),creatinine(Crea)]before treatment and after 7 days of treatment were compared between the two groups.Results After 1,3,7 days of treatment,the 24 h urine output of the combined treatment group was obviously increased compared with those before treatment,and the 24 h urine output(3618±1618),(2618±1628),(2390±950)ml of combined treatment group were obviously more than(1416±605),(1474±625),(1567±693)ml of conventional treatment group.All the difference was statistically significant(P<0.05).After 1,3,7 days of treatment,the blood sodium levels of the combined treatment group were obviously higher than those before treatment,and the blood sodium levels(132.4±6.3),(133.4±6.9),(134.0±6.8)mmol/L of combined treatment group were obviously higher than(128.7±6.4),(128.4±6.6),(129.5±6.7)mmol/L of conventional treatment group.All the difference was statistically significant(P<0.05).After 7 days of treatment,the BUN and Crea of the two groups had no significant change compared with before treatment,and there was no statistically significant difference within and between the two groups(P>0.05).Conclusion Combined application of tolavtan has significant diuretic effect on cirrhosis complicated with refractory ascites and hyponatremia,and can also increase the level of blood sodium.Short-term use has no effect on renal function.

关 键 词：托伐普坦 肝硬化 顽固性腹水 低钠血症 

分 类 号：R575.2[医药卫生—消化系统]