心功能不全伴稀释性低钠血症治疗分析

The treatment analysis of cardiac insufficiency with diluting-style hyponatremia

目的 总结慢性心功能不全伴稀释性低钠血症的临床治疗经验。方法对112例慢性心功能不全（Ⅲ～Ⅳ级）伴稀释性低钠血症患者，除限水、扩张血管、强心治疗外，给予3％氯化钠及呋塞米治疗。比较治疗前后患者的心功能分级、疗效、血钠水平。结果112例患者治疗后，心功能Ⅱ级者90例，Ⅲ级者12例，死亡10例。与治疗前心功能Ⅲ级68例，心功能Ⅳ级者44例比较，差异有统计学意义（P〈0．05）；治疗后显效83例，有效19例，无效10例，总有效率91．1％；治疗后心功能Ⅲ级、Ⅳ级者的血钠分别为（142．4±3．2）mmol／L、（141．1±2．6）mmol／L，与治疗前心功能Ⅲ级、Ⅳ级者的血钠分别为（122．1±1．8）mmol／L、（122．3±2．3）mmol／L比较，差异有统计学意义（P〈0．05）。结论合理利尿、适当补充钠盐有助于减少心功能不全伴稀释性低钠血症患者恶性事件发生的风险，改善患者预后。

Objective To summarize the clinical treatment experiences of chronicity cardiac insufficiency with the diluting-style hyponatremia. Methods Treat 112 patients who were suffering from chronicity cardiac insufficiency with the diluting-style hyponatremia with operating water ingestion limit, blood vessel expansion, myocardial contractility strengthening besides given 3% sodium chloride and furosemide treatment. It was compared the former heart function classification, effective, hyponatremia level with after given treatment. Results One hurdred and tweleve patients after given treatment, 90 patients＇ heart function were level Ⅱ , 12 patients＇ heart function were level Ⅲ, The difference had a statistics meaning（P〈0.05）compare with former 68 patients of level m and 44 patients of level IV; After treatment 83 patients have distinct effective, 19 patients have certain effective, 10 patients have no effective, and the total actovoty ratio was 91.1% ; After treatment, the hyponatrenfia of patients who has different heart function were （142.4±3.2）retool/L, （ 141.1±2.6）mmol/L respectively, The difference has a statistics meaning （both P 〈 0.05） compare with former hyponatremia which are （122.1±1.8）mmol/L,（122.3±2.3）mmol/L. Conclusion Proper diuresis and sodium salt supplement help reduce the malignant risk of the patients suffering from cardiac insufficiency with the diluting- style hyponatremia and improve the prognosis of patients.