托伐普坦联合高渗盐水治疗慢性心衰并低钠血症的效果及对患者生存质量和预后的影响

Effect of tolvaptan combined with hypertonic saline in the treatment of chronic heart failure with hyponatremia and its influence on quality of life and prognosis of patients

目的探究托伐普坦联合高渗盐水治疗慢性心衰伴低钠血症的效果及对患者生存质量和预后的影响。方法将我院收治的90例慢性心衰伴低钠血症患者根据治疗方式的不同分为对照组(45例,常规治疗)与观察组(45例,常规治疗+高渗盐水+托伐普坦)。比较两组治疗效果、疾病相关指标、生存质量及病死率。结果观察组治疗总有效率显著高于对照组(P<0.05)。治疗1周后,两组患者的血清钠水平及LVEF均升高,NT-proBNP、ADH水平均降低,且观察组明显优于对照组(P<0.05)。治疗3个月后,两组患者的MLHFQ评分均降低,且观察组明显低于对照组(P<0.05)。随访半年后,观察组病死率显著低于对照组(P<0.05)。结论托伐普坦联合高渗盐水治疗慢性心衰并低钠血症效果显著,能够提高患者生存质量和预后效果。

Objective To explore the effect of tolvaptan combined with hypertonic saline in the treatment of chronic heart failure with hyponatremia and its influence on quality of life and prognosis of patients. Methods A total of 90 patients with chronic heart failure with hyponatremia in our hospital were divided into control group (45 cases, routine treatment) and observation group (45 cases, routine treatment +hypertonic saline +tolvaptan) according to different treatment methods. The therapeutic effects, disease -related indicators, quality of life and mortality were compared between the two groups. Results The total effective rate of treatment of the observation group was significantly higher than that of the control group (P<0.05). After 1 week of treatment, the levels of serum sodium and LVEF in both groups increased, the levels of NT-proBNP and ADH decreased, and those in the observation group were significantly better than the control group (P<0.05). After 3 months of treatment, the MLHFQ score in both groups decreased, and that of the observation group was significantly lower than the control group (P<0.05). After 6 months of follow-up, the mortality of the observation group was significantly lower than that of the control group (P<0.05). Conclusion Tolvaptan combined with hypertonic saline in the treatment of chronic heart failure with hyponatremia has a significant effect, which can improve the quality of life and prognosis of patients.