托伐普坦治疗顽固性心力衰竭合并低钠血症的效果观察

Effect observation of tolvaptan in the treatment of intractable cardiac failure combined with hyponatremia

目的探讨托伐普坦治疗顽固性心力衰竭合并低钠血症的效果。方法选取2014年8~12月河南省人民医院收治的60例心力衰竭患者作为研究对象,随机分为观察组和对照组,各30例。对照组采用常规治疗,观察组在对照组的基础上给予口服托伐普坦治疗。比较两组治疗前后的尿量、血钠、NT-proBNP及左心室射血分数（LVEF）、左室舒张末期内径（LVEDD）及E/A比值。结果观察组治疗后的尿量为（2635±856）ml/24 h,显著多于对照组的（1360±390）ml/24 h,差异有统计学意义（P〈0.05）。观察组治疗后的体重下降（0.95±0.65）kg/d,显著多于对照组的（0.30±0.45）kg/d,差异有统计学意义（P〈0.05）。观察组治疗后的血钠水平显著高于对照组治疗后,差异有统计学意义（P〈0.05）。观察组治疗后的NT-proBNP水平显著低于对照组治疗后,差异有统计学意义（P〈0.05）。观察组治疗后的LVEF、E/A比值显著高于对照组治疗后,差异有统计学意义（P〈0.05）。观察组治疗后的LVEDD显著低于对照组治疗后,差异有统计学意义（P〈0.05）。结论托伐普坦治疗顽固性心力衰竭合并低钠血症的效果显著,能有效增加血钠浓度和增加尿量,改善心功能。

Objective To explore the effect of tolvaptan in the treatment of intractable heart failure combined with hyponatremia. Methods 60 patients with intractable heart failure combined with hyponatremia from August 2014 to December in people＇s hospital of Henan province were selected and randomly divided into the observation group and the control group,30 cases in each group.The control group was given conventional treatment on heart failure,the obrervation group was given tolvaptan on the basis of the control group.The urine volume,serum sodium,NT-proBNP,left ventrieular ejection fraction （LVEF）,left ventricular end-diastolic diameter（LVEDD） and E/A ratio in two groups before and after treatment was compared. Results The urine volume in the observation group after treatment was （2635±856） ml/d, which was more than （1360±390） ml/d in the control group,with significant difference（P〈0.05）.The falling weight of the observation group after treatment was （0.95±0.65） kg/d,which was more than （0.30±0.45） kg/d of the control group,with significant difference （P〈0.05）.The level of serum sodium in the observation group after treatment was higher than that in the control group after treatment,with significant difference（P〈O.05）.The level of NT-proBNP in the observation group after treatment was lower than that in the control group after treatment,with significant difference（P〈0.05）.LVEF and E/A ratio in the observation group after treatment was higher than that in the control group after treatment,with significant difference（P〈0.05）.LVEDD in the observation group after treatment was lower than that in the control group after treatment,with significant difference（P〈0.05）. Conclusion The effect of tolvaptan in the treatment of intractable cardiac failure combined with hyponatremia ia significant,which can effectively increase serum sodium concentration and urine output,improve cardiac function.