托伐普坦治疗慢性心力衰竭的疗效及安全性

Effect of tolvaptan on patients with chronic heart failure

目的探讨托伐普坦治疗慢性心力衰竭(chronic heart failure,CHF)患者的疗效及安全性。方法将60例CHF患者随机分为对照组与观察组,每组30例。对照组给予常规抗心力衰竭治疗,观察组在对照组基础上加用托伐普坦治疗。于治疗前、治疗后7 d检测24 h尿量、血钠、血钾、尿素氮、肌酐、尿酸、B型利钠肽(BNP)、左室射血分数(LVEF)并评价疗效。结果治疗7 d后,与治疗前相比,两组患者24 h尿量、血钠明显改善,BNP下降,差异有统计学意义(P<0.05)。与对照组治疗后比较,观察组尿素氮、肌酐明显下降,LVEF明显升高,差异有统计学意义(P<0.05);但尿酸、血钾未见明显变化。观察组总有效率(90.0%)高于对照组(63.3%),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论托伐普坦可有效改善CHF患者临床症状,纠正低钠血症,改善心肾功能,且不会引起电解质紊乱,不良反应少。

Objective To explore the curative effect and safety of tolvaptan on patients of chronic heart failure（ CHF）.Methods Sixty patients with chronic heart failure were randomly divided into the control group and observation group（ 30 cases in each group）. The control group was given traditional anti-CHF therapy while the observation group was given traditional anti-CHF therapy plus tolvaptan. The changes of 24 h urine volume、blood sodium、blood potassium、blood urea nitrogen、creatinine、uric acid、B-type natriuretic peptid（ BNP） and left ventricular ejection fraction（ LVEF） were detected before treatment and 7 days after treatment. The curative effect of tolvaptan was assessed. Results After 7 days of treatment,24 h urine volume and blood sodium significantly improved,while the level of BNP decreased in the two groups（ P〈0. 05）. Compared with the control group,the level of blood urea nitrogen and creatinine decreased and LVEF increased in the observation group（ P〈0. 05）. but the level of uric acid and blood potassium did not significantly change. The total effective rate of the observation group（ 90. 0%） was higher than that of the control group（ 63. 3%）（ P〈0. 05）. The difference in the incidence of adverse reactions was of no statistical significance between the two groups（ P〉0. 05）. Conclusions Tolvaptan can effectively improve the clinical symptom,correct low sodium blood sickness,improve the cardiac and renal function,cause no electrolyte disturbances or fewer adverse reactions in patients with chronic heart failure.