摘要
目的评价托伐普坦治疗老年心衰合并低钠血症患者的临床疗效。方法选取2014年9月至2016年6月在我院心内科住院的老年心衰合并低钠血症患者(年龄≥60岁)46例,采用随机数字表法将患者分为托伐普坦组(托伐普坦+常规治疗)和呋塞米组(呋塞米+常规治疗),每组23例,比较两组患者治疗前及治疗后第7天的血钠、脑钠肽(BNP)、尿量、体重、左心室射血分数(LVEF)、生活质量评分情况,同时分析两组用药期间不良反应发生率、住院时间、出院后180 d心血管死亡情况。结果托伐普坦组治疗后第7天较治疗前血清钠、尿量、LVEF升高,BNP、体重、生活质量评分下降(P<0.05)。呋塞米组治疗后第7天较治疗前尿量升高,体重、BNP、生活质量评分降低(P<0.05)。治疗后第7天托伐普坦组较呋塞米组血清钠、尿量、LVEF升高,BNP、体重、生活质量评分降低(P<0.05)。托伐普坦组较呋塞米组住院时间缩短,口干、口渴发生率升高(P<0.05)。两组患者出院后180 d心血管死亡率比较差异无统计学意义(P>0.05)。结论托伐普坦可以显著增加老年心衰合并低钠血症患者的血清钠水平,强效利尿,提高心脏功能,改善短期生活质量,对180 d预后无影响。
Objective To evaluate the clinical efficacy of tolvaptan in elderly patients who had heart failure complicated with hyponatremia. Methods Forty-six patients who had heart failure complicated with hyponatremia were selected in our hospital from September 2014 to June 2016. They were divided randomly into tolvaptan group（ tolvaptan ＋ conventional therapy） and furosemide group（ furosemide ＋ conventional therapy）,23 cases in each group. The blood sodium,brain natriuretic peptide（ BNP）,urine volume,body weight, left ventricular ejection fraction（ LVEF） and the score of quality life before and at 7 d after treatment were recoreed. The incidence of adverse reactions and the duration of hospitalization and the 180-day cardiovascular mortality after discharge were recorded. Results On the 7th day after treatment, the serum sodium,urine volume and LVEF increased in tolvaptan group（ P 0. 05）,while BNP,body weight and the score of life quality decreased significantly（ P 0. 05）; the urine volume in furosemide group increased（ P 0. 05）,while body weight,BNP and score of life quality decreased significantly（ P 0. 05）; the serum sodium,urine volume and LVEF in tolvaptan group were higher,while BNP,body weight and the score of life quality were lower than those of furosemide group（ P 0. 05）. The hospitalized time in tolvaptan group was shorter,while the incidence rate of dry mouth and thirst was higher than that of furosemide group（ P 0. 05）. There was no significant difference in the 180-day cardiovascular mortality between the two groups（ P 0. 05）. Conclusion Tolvaptan can significantly increase the level of serum sodium of elderly patients who have heart failure complicated with hyponatremia; it can improve the heart function and life quality in short term,and has powerful diuretic effects without influence on 180-day prognosis.
出处
《实用药物与临床》
CAS
2017年第6期653-656,共4页
Practical Pharmacy and Clinical Remedies
