托伐普坦治疗肝硬化腹水伴低钠血症研究进展

Research progress of tolvaptan in treatment of cirrhotic ascites with hyponatremia

肝硬化腹水伴低钠血症的治疗是目前临床治疗的一大难题。托伐普坦是一种血管加压素V2受体拮抗药,可以升高血浆中钠离子浓度,抑制肾脏对水的重吸收,促进水分从尿液排出。影响托伐普坦疗效的因素有尿钠浓度、血清钠浓度、肾小球滤过率、血尿素氮水平等。用药期间应注意观察患者血压、心率、血清钠水平、肝功能,及早发现不良反应并对症治疗。

The treatment of cirrhotic ascites with hyponatremia is a difficult problem in clinical treatment.Tolvaptan is an antagonist of vasopressin V2 receptor, which can increase the concentration of sodium ions in plasma, inhibit the reabsorption of water by the kidney, and promote the excretion of water from the urine. Factors influencing the efficacy of tolvaptan include urinary sodium concentration, serum sodium concentration,glomerular filtration rate, blood urea nitrogen level, etc. Attention should be paid to the patient’s blood pressure,heart rate, serum sodium level and liver function during the medication, and adverse reactions should be detected as early as possible and symptomatic treatment can be given.