托伐普坦治疗慢性心力衰竭的疗效

Therapeutic effect of tolvaptan on chronic heart failure

目的:探讨托伐普坦治疗慢性心力衰竭(CHF)的临床疗效。方法:选择2015年6月至2016年6月于我科住院的CHF患者102例。根据随机数字表,患者被分为呋塞米对照组(52例,在常规治疗基础上加用呋塞米)和托伐普坦组(50例,在常规治疗基础上加用托伐普坦)。观察比较两组治疗前后心输出量(CO)、心脏指数(CI)、每搏输出量(SV)及外周血管阻力(SVR),以及治疗效果。结果:与治疗前比较,两组治疗后CO、CI和SV均显著升高,而SVR显著降低(P均<0.01);与呋塞米对照组比较,托伐普坦组治疗后CO[(4.41±0.71)L/min比(4.80±0.77)L/min]、CI[(3.21±0.52)L·min^(-1)·m^(-2)比(3.62±0.78)L·min^(-1)·m^(-2)]和SV[(70.09±14.90)ml比(79.60±13.10)ml]升高更显著,SVR[(3111.30±931.85)dyne·s/cm^5比(2756.68±856.32)dyne·s/cm^5]降低更显著,P<0.05或<0.01。托伐普坦组的治疗总有效率显著高于常规治疗组(100.0%比75.0%),P=0.001。结论:应用托伐普坦治疗慢性心力衰竭,能明显改善心功能,临床疗效显著,值得推广。

Objective： To explore therapeutic effect of tolvaptan on chronic heart failure （CHF）. Methods： A total of 102 CHF patients hospitalized in our hospital from Jun 2015 to Jun 2016 were selected. According to random number table, patients were divided into furosemide control group （n = 52, received furosemide based on routine treatment） and tolvaptan group （n = 50, received tolvaptan based on routine treatment）. Cardiac output （CO）, cardiac index （CI）, stroke volume （SV）, systemic vascular resistance （SVR） and therapeutic effect were observed and compared between two groups before and after treatment. Results： Compared with before treatment, there were significant rise in CO, CI and SV, and significant reduction in SVR in both groups after treatment, P〈0. 01 all; compared with furosemide control group after treatment, there were significant rise in CO [ （4. 41 ± 0.71） L/min vs. （4.80 ± 0.77） L/min], CI [（3.21 ± 0. 52） L · min^-1 · m^2 vs. （3.62± 0.78） L · min^-1 · m^2] and SV [（70. 09± 14.90） ml vs. （79. 60 ± 13.10） ml], and significant reduction in SVR [ （3111.30 ± 931.85） dyne · s/cms vs. （2756.68 ± 856. 32） dyne · s/cm5] in tolvaptan group, P〈0.05 or d0.01. Total effective＇rate of tolvaptan group was significantly higher than that of routine treatment （100.0% vs. 75.0%）, P = 0.001. Conclusion： Tolvaptan can significantly improve heart function in patients with chronic heart failure, its therapeutic effect is significant, so it＇s worth extending.