Objective:This study aims to compare the therapeutic effect and safety between tolvaptan and furosemide in treatment of acute left heart failure complicated with hyponatremia.Methods:This randomized controlled study enrolled 95 patients with acute exacerbation of chronic heart failure complicated with hyponatremia admitted Putian First Hospital between July 2018 and September 2022.They were divided into furosemide group(n=49,routine fu-rosemide intravenous injection)and tolvaptan group(n=46,tolvaptan p.o.).After 7d treatment,clinical thera-peutic effect,cardiac function,electrolyte,serum creatinine(SCr)and incidence of adverse drug reactions were compared between two groups.Results:After 7d treatment,patients in two groups had significant lower level of N terminal pro natriuretic peptide(NT-proBNP),and significant higher left ventricular ejection fraction(LVEF)and blood sodium level(P＜0.05 or＜0.01).Compared with patients in furosemide group,those in tolvaptan group had significant lower SCr level[125.00(107.50,164.00)μmol/L vs.113.00(85.00,130.50)μmol/L],and significant higher blood potassium level[3.60(3.20.4.20)μmol/L vs.3.90(3.60,4.60)μmol/L](P＜0.05 or＜0.01).There were no significant difference in therapeutic effect,cardiac function and incidence of adverse drug reactions between two groups after treatment(P＞0.05 all).Conclusion:Tolvaptan p.o.is safe and effective in treatment of acute heart failure,and its effect is not inferior to intravenous injection of furosemide,especially for those with hyponatremia,which could be applied for short-term treatment of acute heart failure.
维普
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