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疗效观察

Efficacy observation of tolvaptan tablets combined with sacubitril valsartan sodium tablets in the treatment of heart failure with 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疗效。方法50例心力衰竭伴低钠血症患者,采用随机数字表法分为对照组和研究组,每组25例。对照组给予沙库巴曲缬沙坦钠片治疗,研究组在对照组基础上联合托伐普坦片治疗。比较两组治疗效果、不良反应发生情况以及治疗前后美国纽约心脏病学会(NYHA)等级、左心室射血分数(LVEF)、24 h尿量、相关血清指标[钠离子(Na^(+))、钾离子(K^(+))、血肌酐(CREA)、氨基末端B型脑钠肽前体(NT-proBNP)]水平。结果研究组治疗总有效率92.00%高于对照组的64.00%,差异具有统计学意义(P<0.05)。治疗后,研究组NYHA等级(1.42±0.21)级低于对照组的(2.51±0.56)级,LVEF水平(56.45±3.56)%、24 h尿量(2481.12±255.24)ml均高于对照组的(51.25±3.43)%、(1385.24±124.01)ml,差异均具有统计学意义(P<0.05)。治疗后,研究组患者血清Na^(+)(139.21±10.21)mmol/L、K^(+)(4.40±0.52)mmol/L、CREA(107.23±10.24)μmol/L均高于对照组的(133.12±5.70)mmol/L、(4.11±0.35)mmol/L、(98.45±5.56)μmol/L,NT-proBNP(2564.01±120.12)ng/L低于对照组的(2978.34±256.04)ng/L,差异均具有统计学意义(P<0.05)。两组均未出现严重不良反应。对照组不良反应发生率为4.00%(低血压1例),与研究组的4.00%(干咳1例)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确切,可有效改善心功能,且安全性高。

Objective To analyze the efficacy of tolvaptan tablets combined with sacubitril valsartan sodium tablets in the treatment of heart failure with hyponatremia.Methods A total of 50 patients with heart failure with hyponatremia were randomly divided into control group and research group by random numerical table,with 25 cases in each group.The control group was treated with sacubitril valsartan sodium tablets,and the research group was treated with tolvaptan tablets on the basis of the control group.Both groups were compared in terms of therapeutic effect,occurrence of adverse reactions,New York Heart Association(NYHA)grading,left ventricular ejection fraction(LVEF),24-h urine output,and related serum indexes[sodium ion(Na^(+)),potassium ion(K^(+))]before and after treatment,serum creatinine(CREA),N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels.Results The total effective rate 92.00% of the research group was higher than 64.00% of the control group,and the difference was statistically significant(P<0.05).After treatment,the NYHA grading(1.42±0.21)grades of the research group was lower than(2.51±0.56)grades of the control group;the LVEF(56.45±3.56)% and the 24-h urine volume(2481.12±255.24)ml of the research group were higher than(51.25±3.43)% and(1385.24±124.01)ml of the control group;all the differences were statistically significant(P<0.05).After treatment,the serum Na^(+)(139.21±10.21)mmol/L,K^(+)(4.40±0.52)mmol/L,CREA(107.23±10.24)μmol/L in the research group were higher than(133.12±5.70)mmol/L,(4.11±0.35)mmol/L,(98.45±5.56)μmol/L in the control group;the NT-proBNP(2564.01±120.12)ng/L in the research group was lower than(2978.34±256.04)ng/L in the control group;all the differences were statistically significant(P<0.05).There were no serious adverse reactions in either group.The incidence of adverse reactions in the control group was 4.00%(1 case of hypotension),and the difference was not statistically significant compared with 4.00%in the research group(1 case of dry cough)(P>0.05).Conclusion Tolvaptan tablets combined with sacubitril valsartan sodium tablets has definite clinical effect in the treatment of heart failure with hyponatremia,and can effectively improve the cardiac function with high safety.