中文摘要：

目的：探讨新型利水剂V2受体阻滞剂托伐普坦在重度心衰容量控制及心衰改善治疗中的疗效。方法：自我院心血管重症病房收集110例重度心衰患者,随机分为托伐普坦组和常规强化利尿组,托伐普坦组在常规强化利尿的基础上联合使用托伐普坦,观察其入院至出院的过程中容量控制指标及心衰改善指标的变化。分析2组患者在心衰症状缓解或出院例数、死亡或放弃例数;心衰改善存活患者的平均住院日数;治疗前后体质量变化、住院期间平均每日尿量等心衰控制指标及容量控制指标,对比2组患者的治疗效果差异。结果：托伐普坦组患者的心衰症状控制率可达92.7%,而常规强化利尿组仅达78.2%,显著优于对照组,同时,托伐普坦组心衰症状控制更快更强,平均住院时间缩短4 d左右,体质量下降较对照组平均高出3 kg左右。结论：托伐普坦可以显著提高重症心衰患者的容量控制和心衰症状控制,在重症心衰的治疗中具有重大的临床价值。

英文摘要：

OBJECTIVE To investigate effects of new aquaresis agent V2 antagonist tolvaptan on volume control and symptom improvement in patients with advanced heart failure.METHODS A total of 110 patients with advanced heart failure were randomly assigned to tolvaptan group and conventional intensive diuretic group.In tolvaptan group,tolvaptan was added based on conventional intensive diuretic strategy.Parameters,which indicated volume control and heart failure improvement during the hospital admissions,were observed.Reasons were analyzed for patients with heart failure symptoms improved and those successful discharged;death,therapy failure or abandonment;average days hospitalized of survival patients between two groups.Volume control measures were also analyzed,including body weight changes and average daily urine output.Difference was compared between the two groups in heart failure symptom improvement and volume control.RESULTS The success percentage was 92.7%in tolvaptan group,and 78.2%in conventional intensive diuretic group,which were all significantly better than control group.Meanwhile,in tolvaptan group,the average in-hospital duration was 4 days shorter and weight loss was3 kg more than those in the conventional group.CONCLUSION Tolvaptan can significantly improve volume control and alleviate heart failure symptoms in patients with advance heart failure.The aquaresis agent tolvaptan has a great role in treatment against advanced heart failure.