托伐普坦对急性充血性心力衰竭合并慢性肾功能不全患者的治疗效果

目的观察托伐普坦对急性充血性心力衰竭合并慢性肾功能不全的治疗效果。方法将60例患者依据随机数字法分为对照组30例与试验组30例。对照组在常规抗心力衰竭的基础上给予呋塞米注射液,每次20 mg,qd,静脉注射。试验组在常规抗心力衰竭的基础上给予托伐普坦片,每次30 mg,qd,口服。2组治疗时间均为7 d。对比2组患者的左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、血清钠(Na⁺)、血清钾(K⁺)、血清肌酸酐(Scr)、血尿素氮(BUN)、肾小球滤过率(GFR)、疗效和药物不良反应发生情况。结果治疗后,试验组和对照组的有效率分别为96.67%(29例/30例)和73.33%(22例/30例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的LVEF分别为(45.89±3.28)%和(43.58±3.11)%,LVEDD分别为(44.32±3.07)和(47.15±4.25)mm,Scr分别为(154.69±20.11)和(186.41±20.51)μmol·L^-1,BUN分别为(9.67±1.06)和(11.53±1.50)mmol·L^-1,GFR分别为(47.15±2.27)和(42.69±2.33)mL·(min·1.73 m²)^-1,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为3.33%和10.00%,差异无统计学意义(P>0.05)。结论以托伐普坦为主的策略治疗急性充血性心力衰竭合并慢性肾功能不全患者,在短期内有助于改善心功能,纠正电解质紊乱,防止肾功能恶化,提升治疗效果,具有良好的安全性。

Therapeutic effect of tolvaptan on acute congestive heart failure combined with chronic renal insufficiency

Objective To observe the therapeutic effect of tolvaptan on acute congestive heart failure combined with chronic renal insufficiency.Methods According to the random number method,60 patients were divided into control group with 30 cases and treatment group with 30 cases.Control group was given furosemide injection,20 mg each time,qd,intravenously on the basis of conventional anti-heart failure treatment.Treatment group was treated with conventional anti-heart failure therapy and tolvaptan tablets 30 mg each time,qd,orally.The treatment time of both groups was 7 d.The left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),serum sodium(Na⁺),serum potassium(K⁺),serum creatinine(Scr),blood urea nitrogen(BUN),renal small sphere filtration rate(GFR),clinical efficacy,adverse drug reactions in two groups were compared.Results After treatment,the effective rates of treatment group and control group were 96.67%(29 cases/30 cases)and 73.33%(22 cases/30 cases),with significant difference(P<0.05).After treatment,the LVEF in treatment group and control group were(45.89±3.28)%and(43.58±3.11)%,LVEDD were(44.32±3.07)and(47.15±4.25)mm,Scr were(154.69±20.11)and(186.41±20.51)μmol·L^-1,BUN were(9.67±1.06)and(11.53±1.50)mmol·L^-1,GFR were(47.15±2.27)and(42.69±2.33)m L·(min·1.73 m²)^-1,the data were all with significant difference(all P<0.05).The incidence of adverse drug reactions in treatment group and control group during treatment were 3.33%and 10.00%,without significant difference(P>0.05).Conclusion Using tolvaptan as the main strategy for the treatment of patients with acute congestive heart failure combined with chronic renal insufficiency,which helped improve heart function,corrected electrolyte disturbances,prevent deterioration of renal function,and improved the treatment effect in the short term,with good safety.