托伐普坦片联合沙库巴曲缬沙坦钠片治疗心力衰竭伴低钠血症患者的临床疗效分析

Analysis of the clinical efficacy of tolvaptan tablets combined with sacubitril valsartan sodium tablets in the treatment of patients with heart failure and hyponatremia

目的分析托伐普坦片联合沙库巴曲缬沙坦钠片治疗心力衰竭伴低钠血症患者的临床疗效。方法30例心力衰竭伴低钠血症患者,随机分为对照组和干预组,各15例。对照组患者给予沙库巴曲缬沙坦钠片治疗,干预组在对照组基础上给予托伐普坦片治疗。比较两组治疗前后临床指标[纽约心脏病协会(NYHA)分级、血清钠、血清钾、血肌酐、N末端B型脑钠肽前体(NT-proBNP)、24 h尿量、左心室射血分数)、临床疗效及不良反应发生情况]。结果治疗后,干预组24 h尿量(2481.67±255.21)ml、血清钠(139.21±10.71)mmol/L、血清钾(4.45±0.52)mmol/L、血肌酐(107.21±10.71)μmol/L、左心室射血分数(56.24±3.42)%均高于对照组的(1385.21±124.56)ml、(133.24±5.75)mmol/L、(4.01±0.35)mmol/L、(98.21±5.76)μmol/L、(51.21±3.41)%,NT-proBNP(2564.22±120.52)pg/ml、NYHA分级(1.52±0.21)级均低于对照组的(2978.13±156.56)pg/ml、(2.54±0.56)级,差异有统计学意义(P<0.05)。干预组总有效率91.11%高于对照组的75.56%,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)。结论托伐普坦片联合沙库巴曲缬沙坦钠片治疗心力衰竭伴低钠血症的临床效果显著,对心功能和机体电解质改善明显,值得推广。

Objective To analyze the clinical efficacy of tolvaptan tablets combined with sacubitril valsartan sodium tablets in the treatment of patients with heart failure and hyponatremia.Methods A total of 30 patients with heart failure and hyponatremia were randomly divided into the control group and the intervention group,each with 15 cases.Patients in the control group were treated with sacubitril valsartan sodium tablets,and the intervention group was treated with tolvaptan tablets on the basis of the control group.Both groups were compared in terms of clinical indicators[New York Heart Association(NYHA)classification,serum sodium,serum potassium,serum creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP),24-h urine output,left ventricular ejection fraction)before and after treatment,clinical efficacy and occurrence of adverse reactions.Results After treatment,the 24-h urine output,serum sodium,serum potassium,serum creatinine,and left ventricular ejection fractionent of the intervention group were(2481.67±255.21)ml,(139.21±10.71)mmol/L,(4.45±0.52)mmol/L,(107.21±10.71)μmol/L,and(56.24±3.42)%,which were higher than(1385.21±124.56)ml,(133.24±5.75)mmol/L,(4.01±0.35)mmol/L,(98.21±5.76)μmol/L,(51.21±3.41)%of the control group;NT-proBNP(2564.22±120.52)pg/ml and NYHA classification(1.52±0.21)grades of the intervention group were lower than(2978.13±156.56)pg/ml and(2.54±0.56)grades of the control group;all the differences were statistically significant(P<0.05).The total effective rate 91.11%in the intervention group was higher than 75.56%in the control group,and the difference was statistically significant(P<0.05).The difference was not statistically significant when comparing the incidence of adverse reactions between the two groups(P>0.05).Conclusion Tolvaptan tablets in combination with sacubitril valsartan sodium tablets has significant clinical effect on the treatment of heart failure and hyponatremia,and it an obviously improve the heart function and body electrolytes.It is worthy of promotion.