Clinical effect of tolvaptan in the treatment of chronic pulmonary heart disease complicated with right heart failure
Objective To observe the clinical effect of tolvaptan in the treatment of chronic pulmonary heart disease(CPHD)complicated with right heart failure(RHF).Methods A total of 60 patients with CPHD complicated with RHF hospitalized in our hospital from May 2018 to May 2022 were selected as the research objects.The patients were divided into observation group(treated with tolvaptan on the basis of conventional comprehensive treatment)and control group(treated with furosemide tablets on the basis of conventional comprehensive treatment)according to treatment plan,with 30 cases in each group.The improvement of symptoms and physical signs,average 24 h urine volume within 1 week after medication,hospitalization time,30 d readmission rate due to RHF,N-terminal pro-brain natriuretic peptide(NT-proBNP)level and adverse reactions were compared between the two groups.Results The total effective rate of improvement of symptoms(dyspnea)at 24 h after medication in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).The total effective rate of improvement of physical signs(lower limb edema)at 48 h after medication in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).The average 24 h urine volume within 1 week after medication in the observation group was more than that in the control group,the hospitalization time was shorter than that in the control group,the 30 d readmission rate due to RHF was lower than that in the control group,and the differences were statistically significant(P＜0.05).Before treatment,there was no significant difference in NT-proBNP level between the two groups(P＞0.05);after treatment,the level of NT-proBNP in the two groups was lower than that before treatment,and the difference was statistically significant(P＜0.05);after treatment,the level of NT-proBNP in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Tolvaptan can significantly alleviate the symptoms(dyspnea)and physical signs(lower limb edema)of patients with CPHD complicated with RHF,increase urine volume,shorten hospitalization time,and reduce the 30 d readmission rate due to RHF,NT-proBNP level and incidence of adverse reactions,which is worthy of clinical application and promotion.
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