|本期目录/Table of Contents|

[1]吴章民,袁方.托伐普坦治疗左心瓣膜置换术后三尖瓣关闭不全伴右心衰的临床研究[J].国际心血管病杂志,2018,02:105-108.
　WU Zhangmin,YUAN Fang..Efficacy and safety of tolvaptan in the treatment of right heart failure with tricuspid insufficiency after left heart valve replacement[J].International Journal of Cardiovascular Disease,2018,02:105-108.
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托伐普坦治疗左心瓣膜置换术后三尖瓣关闭不全伴右心衰的临床研究

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2018年02期
页码:
105-108
栏目:
临床研究
出版日期:
2018-03-25

文章信息/Info

Title:
Efficacy and safety of tolvaptan in the treatment of right heart failure with tricuspid insufficiency after left heart valve replacement
作者:
吴章民; 袁方
200336 上海交通大学医学院附属同仁医院心内科(吴章民),急诊科(袁方)
Author(s):
WU Zhangmin1;  YUAN Fang2.
1.Department of Cardiology; 2.Department of Emergency, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
关键词:
托伐普坦;  左心瓣膜置换术后;  三尖瓣关闭不全;  右心衰
Keywords:
Tolvaptan;  Left heart valve replacement;  Tricuspid insufficiency;  Right heart failure
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2018.02.011
文献标识码:
-
摘要:
目的:探讨托伐普坦治疗左心瓣膜置换术后三尖瓣关闭不全伴右心衰患者的疗效及安全性。方法:40例左心瓣膜置换术后三尖瓣关闭不全伴右心衰患者随机分为托伐普坦组(n=20,托伐普坦15 mg/d+托拉塞米20 mg/d)和对照组(n=20,托拉塞米20 mg/d),连续治疗10 d,观察两组用药前后体质量、24 h尿量、脑钠肽(BNP)、三尖瓣环收缩期位移(TAPSE),同时记录脉搏、血压、肝肾功能、血钠及药物不良反应。结果:与对照组相比,托伐普坦组体质量降低更多,24 h尿量更大,治疗后两组BNP[(221.45±211.15)pg/mL对(621.65±777.52)pg/mL]、TAPSE[(16.54±2.63)mm 对(14.69±1.54)mm]的差异均有统计学意义(P均<0.05)。治疗前后两组脉搏、血压、肝肾功能指标均无明显变化。托伐普坦组血钠较用药前升高,两组差异有统计学意义(P<0.05),但血钠均在安全范围(<148 mmol/L)。治疗过程中,两组均未出现严重不良事件。结论:托伐普坦治疗左心瓣膜置换术后三尖瓣关闭不全伴右心衰是有效且安全的。
Abstract:
Objective:To examine the efficacy and safety of tolvaptan in the treatment of right heart failure(HF)with tricuspid insufficiency(TI)after left heart valve replacement.Methods:Forty patients with right HF and TI after left heart valve replacement were randomly assigned into tolvaptan group and control group with 20 in each group. Patients in tolvaptan group were given tolvaptan 15 mg/d combined with torasemide 20 mg/d, while the control group was given torasemide 20 mg/d in monotherapy. Both groups were administrated continuously for 10 days and observed for the changes of body weight, 24 hours urine volume, brain natriuretic peptide(BNP)and tricuspid annular plane systolic excursion(TAPSE). Meanwhile, the pulse, blood pressure, liver function, renal function, blood sodium concentration and adverse reactions of both cohorts were recorded.Results:Compared with the control group, the body weight loss was more obvious, 24 hours urine volume was higher, BNP was lower [(221.45±211.15)pg/mL vs.(621.65±777.52)pg/mL] and TAPSE was higher [(16.54±2.63)mm vs.(14.69±1.54)mm] in the tolvaptan group after treatment, and the differences were statistically significant(all P<0.05).The differences of pulse, blood pressure, liver function and renal function between the two groups had no statistical significance. Although the difference of blood sodium concentration between the two groups after treatment were statistically significant(P<0.05), it was in safe range all the way(<148 mmol/L). Throughout the study, there was no serious adverse event in each group.Conclusions:Tolvaptan is effective and safe in the treatment of right heart failure with tricuspid insuffcicency after left heart valve replacement.

参考文献/References

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备注/Memo

备注/Memo:
基金项目:上海市长宁区急性心衰特色专科(20162002)
通信作者:袁方,Email:yuanfangysh@126.com
更新日期/Last Update: 2018-04-20