托伐普坦治疗利尿剂抵抗心力衰竭患者的临床研究

发布时间：2018-03-17 07:23

本文选题：托伐普坦　切入点：心力衰竭　出处：《中国药房》2017年29期 　论文类型：期刊论文

【摘要】：目的:评估托伐普坦治疗利尿剂抵抗心力衰竭患者的临床效果及安全性。方法:回顾性分析2014年1月-2016年8月在重庆医科大学附属第一医院心血管内科病房住院的21例利尿剂抵抗心力衰竭患者的临床资料。所有患者在接受大剂量袢利尿剂(呋塞米和/或托拉塞米)治疗后,心力衰竭改善不明显;后改为托伐普坦治疗,其中19例患者口服托伐普坦片7.5 mg,qd,2例患者口服托伐普坦片15 mg,qd,均连续治疗直至出院。比较21例患者治疗前后的心功能、水肿程度、结局及体质量、血压、血钠、血肌酐、血N末端B型利钠肽原(NT-proBNP)水平和单位时间尿量的变化,并观察不良反应发生情况。结果:治疗后,21例患者心功能明显改善、水肿程度明显减轻、收缩压明显降低、血钠明显升高、单位时间尿量明显增多,与治疗前比较差异均有统计学意义(P0.05);但治疗前后体质量、舒张压、血肌酐和血NT-proBNP水平比较,差异均无统计学意义(P0.05)。21例患者中有1例出现口干,3例收缩压较基础值降低20 mm Hg及以上,4例舒张压较基础值降低10 mm Hg及以上。结论:对出现利尿剂抵抗的患者,托伐普坦能显著增加其尿量、改善心功能、纠正低钠血症,且对收缩压有降低作用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of Tofaptan in the treatment of patients with diuretic resistance to heart failure. Methods: retrospective analysis was conducted from January 2014 to August 2016 in the Department of Cardiovascular Medicine, the first affiliated Hospital of Chongqing Medical University. All patients were treated with high-dose loop diuretics (furosemide and / or Tora Semide). The improvement of heart failure was not obvious, and was changed to torvalptan treatment. Among them, 19 patients were treated with oral Tofaptan tablet 7.5 mg / kg QD, and 2 patients were treated with Tofaptan tablet (15 mg / g QD) continuously until discharge. The cardiac function and edema of 21 patients were compared before and after treatment, and the degree of edema was compared before and after treatment. Outcome and body mass, blood pressure, blood sodium, serum creatinine, serum N-terminal B-type natriuretic peptide (NT-proBNPs) level and urine volume per unit time were observed and adverse reactions were observed. Results: the cardiac function of 21 patients was significantly improved after treatment. The degree of edema was obviously reduced, systolic blood pressure was decreased, blood sodium was obviously increased, urine volume per unit time was obviously increased, and there were significant differences between before and after treatment (P 0.05), but body mass, diastolic blood pressure, serum creatinine and NT-proBNP levels were compared before and after treatment. There was no significant difference in systolic blood pressure (SBP) between 1 case of 21 patients and 20 mm Hg of basal value and 4 cases of diastolic blood pressure decreased 10 mm Hg or more than the base value. Conclusion: to the patients with diuretic resistance, the systolic blood pressure of 3 cases is 20 mm Hg lower than the basic value and the diastolic blood pressure of 4 cases above the base value is lower than 10 mm Hg. Conclusion: there is no significant difference between the two groups. Tofaptan could significantly increase urine volume, improve cardiac function, correct hyponatremia, and decrease systolic blood pressure.
【作者单位】：重庆医科大学附属第一医院心血管内科;重庆医科大学公共卫生与管理学院流行病学教研室;
【基金】：“十二五”国家科技支撑计划项目(No.2011BAI11B01)
【分类号】：R541.6

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