托伐普坦治疗常规利尿剂应答不佳合并轻中度低钠血症肝硬化腹水患者的疗效OA

Objective To evaluate the clinical efficacy and safety of tolvaptan in patients with cirrhotic ascites.Methods A total of 106 patients with cirrhotic ascites admitted to Puyang Hospital of Traditional Chinese Medicine from January 2022 to June 2024 were randomly divided into two groups,with 53 patients in each group.The control group received the potent diuretic furosemide and the aldosterone receptor antagonist spironolactone,whereas the experimental group additionally received tolvaptan.Efficacy and safety were assessed after 4 weeks of treatment.,with a maximum treatment duration of 12 weeks.Clinical efficacy,liver function-related indicators,urine output,body weight,abdominal circumference,and adverse reactions were compared between the two groups.Results After treatment,the clinical response rate and 24-h urine output were higher in the experimental group than in the control group,whereas body weight and abdominal circumference were lower.Alanine aminotransferase and total bilirubin levels were lower,whereas albumin levels were higher,in the experimental group than in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Tolvaptan demonstrates favorable clinical efficacy in patients with cirrhotic ascites,mild-to-moderate hyponatremia,and an inadequate response to conventional diuretics.It can improve the clinical response rate,alleviate ascites,reduce fluid accumulation,and may help ameliorate hepatocellular injury and improve liver function without significantly increasing the risk of adverse reactions.