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目的观察托伐普坦治疗心力衰竭合并低钠血症的临床效果。方法选取2015年1月~2015年12月住院治疗的64例心力衰竭合并低钠血症患者,将其随机分为治疗组和对照组,每组32例。对照组给予常规治疗,治疗组在常规治疗基础上给予托伐普坦。记录两组患者每日24小时尿量及清晨体重,检测并比较治疗前后血清钠、血清氮末端脑钠素原(NT-pro BNP)、抗利尿激素(ADH)水平及左室射血分数(LVEF)情况。结果治疗后,托伐普坦组患者尿量明显增加(P<0.01)、体重迅速降低(P<0.05),快速增高血清钠水平、降低ADH水平(P<0.05),明显降低NT-pro BNP水平、提高LVEF(P<0.05),优于对照组(P<0.05)。结论论托伐普坦可安全、有效地纠正低钠血症,改善心功能,抑制神经内分泌因子,适用于治疗合并低血钠症的心力衰竭患者,值得临床推广。
Objective To observe the clinical effect of tolvaptan in treating heart failure with hyponatremia. Methods 64 cases of hospitalized patients with heart failure and hyponatremia admitted from January 2015 to December 2015 were randomly divided into treatment group and control group, with 32 cases in each group. The control group was given routine treatment, and the treatment group was treated with tolvaptan on the basis of routine treatment. The urine volume and morning weight of 24 hours were recorded in both groups. Serum sodium, serum NT-proBNP, ADH and left ventricular ejection fraction (LVEF) were measured and compared before and after treatment LVEF) situation. Results After treatment, the urinary output of tolvaptan group was significantly increased (P <0.01), body weight was decreased rapidly (P <0.05), the serum sodium level was rapidly increased, the level of ADH was decreased (P <0.05) (P <0.05), which was better than that of the control group (P <0.05). Conclusions Tolvaptan can safely and effectively correct hyponatremia, improve cardiac function and inhibit neuroendocrine factors. It is suitable for treating heart failure patients with hyponatremia and is worthy of clinical promotion.