托伐普坦治疗慢性心力衰竭伴低氯血症的临床效果  

Clinical effect of Tolvaptan in treatment of chronic heart failure with hypochloremia

作　　者：姚璋璐 董彬 YAO Zhang-lu;DONG Bin(Changzhi Medical College,Shanxi Province,Changzhi 046000,China;Department of Cardiovascular Medicine,Heping Hospital Affiliated to Changzhi Medical College,Shanxi Province,Changzhi 046000,China)

机构地区：[1]长治医学院,山西长治046000 [2]长治医学院附属和平医院心血管内科,山西长治046000

出　　处：《中国当代医药》2021年第25期76-79,共4页China Modern Medicine

基　　金：长治医学院附属和平医院院级科研基金项目(HPYJ201940)。

摘　　要：目的探讨托伐普坦治疗慢性心力衰竭(CHF)合并低氯血症的临床疗效。方法回顾性选择2018年9月—2019年6月长治医学院附属和平医院收治的60例CHF合并低氯血症患者作为研究对象,按照治疗方法分为观察组(30例)和对照组(30例)。对照组使用袢利尿剂,观察组使用托伐普坦,治疗时间均为1周。比较两组的用药前后血清氯、血清钠、血清钾、尿素氮、血清肌酐、血碳酸氢(HCO^(-)_(3))、血清白蛋白,氨基末端脑钠肽前体(NT-proBNP)、临床症状及出院后半年内心血管病再住院率。结果治疗后观察组的显效率高于对照组,差异有统计学差异(P<0.05)。治疗后观察组的尿素氮、血肌酐、NT-proBNP水平低于对照组,血氯水平高于对照组,差异有统计学意义(P<0.05);两组的血清白蛋白、HCO^(-)_(3)、血钾、血钠水平比较,差异无统计学意义(P>0.05)。两组治疗6个月期间的心血管病再住院率比较,差异无统计学意义(P>0.05)。结论CHF合并低氯血症患者使用托伐普坦在短期内可改善低氯血症,改善心功能和肾功能。Objective To explore the clinical effect of Tolvaptan in the treatment of chronic heart failure(CHF)with hypochloremia.Methods A total of 60 patients with CHF combined with hypochloremia treated in Heping Hospital Affiliated to Changzhi Medical College from September 2018 to June 2019 were retrospectively selected as research subjects.They were divided into the control group(n=30)and the observation group(n=30)according to the treatment method.Loop diuretic was given to the control group,and Tolvaptan was given to the observation group.The treatment time was one week.The serum chloride,serum sodium,serum potassium,urea nitrogen,serum creatinine,serum hydrogen carbonate(HCO^(-)_(3)),serum albumin,N-terminal pro brain natriuretic peptide(NT-proBNP)before and after treatment in the two groups were compared.The clinical symptom and the rehospitalization rate of cardiovascular disease in half a year after discharge in the two groups were also compared.Results The significant efficiency in the observation group after treatment was higher than that in the control group,with statistically significant difference(P<0.05).The levels of urea nitrogen,serum creatinine and NT-proBNP in the observation group after treatment were lower than those in the control group,and the serum chloride level in the observation group after treatment was higher than that in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in the levels of serum albumin,HCO^(-)_(3),serum sodium(P>0.05).There was no statistically significant difference in the rehospitalization rate of cardiovascular disease 6 months of treatment between the two groups(P>0.05).Conclusion The use of Tolvaptan in patients with CHF and hypoch-loremia can improve hypochloremia,heart function and renal function in the short term.

关 键 词：慢性心力衰竭 低氯血症 托伐普坦 袢利尿剂 

分 类 号：R541.6[医药卫生—心血管疾病]