Efficacy And Safety Of Tolvaptan Combined With Levosimendan In Patients With Refractory Heart Failure

Objective:To analyze the efficacy and safety of tolvaptan combined with levosimendan in patients with refractory heart failure.Methods:90 patients with refractory heart failure admitted to The third affiliated hospital of Nanchang university from January 2018 to January 2020 were included in this study,and they were divided into a control group(45 cases)and a study group(45 cases)according to the random number table method.The control group was treated with conventional anti-heart failure drugs,while the study group was treated with tolvaptan combined with levosimendan treatment based on conventional anti-heart failure drugs.The clinical symptoms,echocardiographic parameters,NT-ProBNP,and 6 min Walking distance,urine output,electrolytes and other indicators,before and after treatment were compared between the two groups,and statistics of adverse reactions to analyze and observe the clinical efficacy and safety.Results:The clinical symptoms,signs of dyspnea,lung wet rales,and lower extremity edema scores of the study group were lower than the control group,the heart rate was slightly faster than the control group,the urine volume at 24 hours was more than the control group,and the blood pressure was lower than the control group The difference was statistically significant(P <0.05).The LVEDD and LVESD of the study group were lower than the control group,and the LVEF,E/A value were higher than the control group,and the comparison between the groups was statistically significant(P <0.05).The level of NT-ProBNP in the study group was lower than that in the control group,and the distance of the 6-minute walk test was longer than that in the control group,The difference was statistically significant(P <0.05).The blood Na + and K + in the study group were higher than those in the control group,and Scr and BUN were lower than the control group.The total incidence of adverse reactions in the study group was 8.89%,which was significantly lower than that in the control group was 24.44%,which was statistically significant(P <0.05).The total clinical effective rate in the study group was 95.56%,which was significantly higher than that in the control group was 82.22%,The contrast difference was statistically significant(P <0.05).Conclusion:When patients with refractory heart failure are treated,the clinical effect of tolvaptan combined with levosimendan is better,which can significantly improve the clinical symptoms of patients and improve the heart function of patients with heart failure.It didn't affects renal function and avoids electrolyte disturbance,reduces adverse reactions,effectively improves the clinical efficacy,and has high safety.It is worth promoting in clinical treatment.