Application of Tolvaptan combined with Furosemide in patients with heart failure complicated with renal insufficiency
WU Chun-yan1 ZENG Hai-yan2▲
1. Department of Cardiology, the Third Affiliated Hospital of Hengyang Medical College, University of South China, Hu′nan Province, Hengyang 421900, China; 2. Department of Cardiology, the Second Affiliated Hospital of Hengyang Medical College, University of South China, Hu′nan Province, Hengyang 421001, China
Abstract：Objective To investigate the effect of Tolvaptan combined with Furosemide in the treatment of heart failure complicated with renal insufficiency. Methods A total of 70 patients with heart failure complicated with renal insufficiency admitted to the Third Affiliated Hospital of University of South China and the Second Affiliated Hospital of University of South China from December 2019 to December 2020 were selected as the research subjects, and were divided into experimental group (35 cases) and control group (35 cases) by random number table method. The experimental group was treated with topaptan combined with furosemide, while the control group was treated with furosemide. The cardiac function classification, urine volume, body weight, blood pressure, N-terminal B-type natriuretic peptide (NTproBNP), electrolyte and renal function changes were compared between the two groups after treatment. Results The grading of cardiac function in the experimental group was better than that in the control group, and the difference was statistically significant (P＜0.05). There were no significant differences in urine volume, body weight and blood pressure between the two groups before treatment (P＞0.05). After treatment, the weight of the experimental group was lower than that of the control group, and the difference was statistically significant (P ＜0.05). In the experimental group, urine volume after treatment was higher than before treatment and body weight was lower than before treatment, with statistical significance (P＜0.05). There was no significant difference in blood pressure between the two groups before and after treatment (P＞0.05). There was no significant difference in NT-probNP and electrolyte between the two groups before treatment (P＞0.05). After treatment,nT-probNP in the experimental group was lower than that in the control group, and blood potassium level was higher than that in the control group, with statistical significance (P＜0.05). After treatment, nT-probNP in the experimental group was lower than before treatment, and blood potassium level in the control group was lower than before treatment,the difference was statistically significant (P＜0.05). There were no significant differences in sodium and chlorine levels between the two groups before and after treatment (P＞0.05). There was no significant difference in renal function indexes between the two groups before treatment (P＞0.05). After treatment, the levels of urea nitrogen and creatinine in the experimental group were lower than those in the control group, and the glomerular filtration rate was higher than that in the control group, with statistical significance (P＜0.05). Conclusion Tolvaptan can effectively improve the symptoms and biochemical indicators of patients with heart failure and renal insufficiency, increase urine output, improve fluid balance, and have a good overall tolerance. It has great clinical value in the treatment of refractory heart failure.
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