托伐普坦片治疗收缩性心力衰竭患者的临床效果与安全性  

Clinical effect and safety of tolvaptan tablets in the treatment of patients with systolic heart failure

作　　者：蔺丽媛 罗晓利 孙敏[2] LIN Liyuan;LUO Xiaoli;SUN Min(Xianyang Central Hospital,Xianyang 712000;Traditional Chinese Medicine Hospital of Baoji,Baoji 721001,China)

机构地区：[1]咸阳市中心医院,陕西咸阳712000 [2]宝鸡市中医医院,陕西宝鸡721001

出　　处：《临床医学研究与实践》2022年第19期43-46,共4页Clinical Research and Practice

基　　金：宝鸡市卫生健康委员会2019年度科研计划立项课题(No.2019-27)。

摘　　要：目的探讨托伐普坦片治疗收缩性心力衰竭(SHF)患者的临床效果与安全性。方法选取2019年1月至2020年12月我院接收的60例SHF患者作为研究对象,依据入院编号的奇偶性将其分为参照组与试验组,各30例。参照组实施呋塞米治疗,试验组实施托伐普坦片治疗。比较两组的临床疗效、生化指标、肺血管指标、心功能指标、不良反应发生情况、炎症指标水平。结果试验组的治疗总有效率为96.67%,显著高于参照组的80.00%(P<0.05)。治疗后1周,试验组的K^(+)、Na^(+)水平高于治疗前及参照组,脑钠素(BNP)水平、肺动脉压、肺毛细血管压低于治疗前及参照组(P<0.05)。治疗后1周,两组的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVSD)、心率(HR)均减小,心脏排血指数(CI)、左心室射血分数(LVEF)均增大,且试验组的LVEDD、LVSD、HR小于参照组,CI、LVEF大于参照组(P<0.05)。试验组的不良反应总发生率为13.33%,显著低于参照组的40.00%(P<0.05)。治疗后1周,两组的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)水平均降低,且试验组低于参照组(P<0.05)。结论托伐普坦片治疗SHF的效果显著,可以改善生化指标、肺血管指标、心功能指标,且不良反应发生率低,安全性高。Objective To investigate the clinical effect and safety of tolvaptan tablets in the treatment of patients with systolic heart failure(SHF). Methods A total of 60 patients with SHF admitted in our hospital from January 2019 to December 2020 were selected as the research objects. According to the parity of admission number, the patients were divided into reference group and experimental group, with 30 cases in each group. The reference group was treated with furosemide, and the experimental group was treated with tolvaptan tablets. The clinical efficacy, biochemical indexes,pulmonary vascular indexes, cardiac function indexes, occurence of adverse reactions and inflammatory indexes were compared between the two groups. Results The total effective rate of treatment in the experimental group was 96.67%,which was significantly higher than 80.00% of the reference group(P<0.05). One week after treatment, the K^(+)and Na^(+)levels in the experimental group were higher than those before treatment and the reference group, while the brain natriuretic peptide(BNP) level, pulmonary artery pressure and pulmonary capillary pressure were lower than those before treatment and the reference group(P <0.05). One week after treatment, the left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVSD) and heart rate(HR) of the two groups decreased, while cardiac index(CI) and left ventricular ejection fraction(LVEF) increased, the LVEDD, LVSD and HR of the experimental group were lower than those of the reference group, and CI and LVEF were higher than those of the reference group(P<0.05).The total incidence of adverse reactions in the experimental group was 13.33%, which was significantly lower than 40.00%in the reference group(P<0.05). One week after treatment, the levels of C-reactive protein(CRP), interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and transforming growth factor-β1(TGF-β1) in the two groups decreased, and those in the experimental group were lower than the reference group(P<0.05).

关 键 词：收缩性心力衰竭 托伐普坦片 呋塞米 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]