顽固性心力衰竭合并中重度稀释性低钠血症治疗方案探讨

Treatment of Refractory Heart Failure with Moderate to Severe Dilute Hyponatremia

目的:探讨顽固性心力衰竭合并中重度稀释性低钠血症优化治疗方案的疗效。方法:选取19例顽固性心力衰竭合并中重度稀释性低钠血症的患者,分别予以高张盐水补钠,托拉塞米利尿,多巴胺改善肾血流量等个体化治疗,比较治疗前后的心功能、血钠、肾功能、血BNP及射血分数的变化。结果:治疗后患者心功能改善总有效率89.6%,血钠、血BNP、射血分数均有明显的改变,差异均有统计学意义(P<0.05),肾功能(血肌酐)差异没有统计学意义(P>0.05)。结论:高张盐水补钠,强化利尿,多巴胺改善肾血流量等个体化的治疗方案对顽固性心力衰竭合并中重度稀释性低钠血症是安全有效的。

Objective：To explore the curative effect of refractory heart failure with moderate to severe dilute hyponatremia.Methods：A total of 19 patients with refractory heart failure complicated with moderate to severe dilute hyponatremia were treated with hypertonic saline sodium, thalidomide diuretic,dopamine to improve renal blood flow and other individual treatment, then compare cardiac function,serum sodium,renal function,blood BNP,ejection fraction changes before and after treatment.Results：After treatment,cardiac function improved total effective rate （P〈0.05）.There was no significant difference in renal function （serum creatinine） between the two groups （P〉0.05）.Conclusion：Individualized treatment plan of hypertonic saline suppository, fortified diuretic,dopamine to improve renal blood flow is safe and effective for refractory heart failure with moderate to severe dilute hyponatremia.