【摘要】 目的比较分析托伐普坦与托拉塞米治疗慢性心衰急性发作的疗效。方法选取医院收治的慢性心衰急性发作患者78例,按入院先后顺序编号,采用奇偶法分为托拉塞米组及托伐普坦组,各39例。两组均给予常规抗心衰治疗,在此基础上,托拉塞米组静脉滴注托拉塞米治疗,托伐普坦组口服托伐普坦。对比两组治疗前后各项生化指标及24 h尿量变化。结果治疗后,两组肌酐值均有所下降,但托拉塞米组仍略高于正常值,而托伐普坦组已恢复至正常范围(P<0.05);托拉塞米组血钠呈下降趋势,而托伐普坦组的血钠较平稳,始终维持在正常范围内(P<0.05);两组血钾、血氯均恢复到正常范围(P>0.05)。治疗后,两组24 h尿量均呈上升趋势,且治疗后第7 d时,托伐普坦组24 h尿量明显高于托拉塞米组(P<0.05)。结论与静脉滴注托拉塞米治疗比较,服用托伐普坦治疗慢性心衰急性发作的效果更好,也可有效去除患者体液储留。更多还原

【Abstract】 Objective To compare the effects of tolvaptan and torasemide in the treatment of acute attack of chronic heart failure. Methods A total of 78 patients who had got an acute attack of chronic heart failure and had been admitted to our hospital were selected and randomly divided into a torasemide group and a tolvaptan group(n =39, respectively) according to the order of admission. Both groups were treated with conventional anti heart failure therapy, and, on this basis, the torasemide group was further treated with torasemide by intravenous drip, and the tolvaptan group orally took tolvaptan. The changes of various biochemical indicators and 24 h urine volume before and after the treatment between the two groups were compared. Results The value of the post-treatment creatinine in the two groups decreased. The value in the torasemide group was slightly higher than the normal value,while that in the tolvaptan group restored to the normal range(P < 0.05); the blood sodium in the torasemide group decreased, while that in the tolvaptan group was stable and always in the normal range(P < 0.05); the blood potassium and blood chloride in the two groups restored to the normal range(P > 0.05). After the treatment, the 24 h urine volume in the two groups increased; on the seventh day of treatment, the 24 h urine volume in the tolvaptan group was significantly higher than that in the torasemide group(P < 0.05).Conclusion Compared with intravenous drip of torasemide, tolvaptan has better effects in the treatment of acute attack of chronic heart failure and can effectively remove fluid retention.更多还原