Comparison Of Effectiveness And Safety Analysis Of Tolvaptan And Traditional Diuretics On Cirrhotic Ascites With Hyponatremia

Objective:To observe the efficacy of tolvaptan and traditional diuretics in patients with cirrhotic ascites and hyponatremia,and to analyze the safety of tolvaptan in patients with cirrhotic ascites and hyponatremia,so as to explore safer and more effective treatment options for cirrhotic ascites with hyponatremia.Methods:140 patients with cirrhotic ascites and hyponatremia admitted to The First Affiliated Hospital of Zhengzhou University from June 2018 to June 2019 were selected,and the patients were divided into the experimental group and the control group by random number table and random block design.Both groups were given the corresponding etiological treatment,liver protection support conventional treatment.In the experimental group,70 patients were given tolvaptan 15mg orally once a day on the basis of conventional treatment.In the control group,70 patients were given furosemide 80mg and spironolactone 1 00mg orally once a day on the basis of conventional treatment.The drug was administered for 2 weeks.Recorded before and after treatment serum sodium,potassium,and ALT,abdominal circumference,ascites depth,the change of body weight,serum creatinine,blood pressure index and the occurrence of adverse reactions during the treatment,observation of tolvaptan and traditional diuretics in patients with cirrhotic ascites and hyponatremia curative effect comparison,analy sis of tolvaptan the safety of the patients with liver cirrhotic ascites and hyponatremia.The date of this study were all selected by SPSS 21.0 statistical analysis software.Quantitative data were compared between groups and within groups using independent samples t-test,and expressed as mean±standard deviation(x±s).The qualitative data was compared between groups using the χ2 test.P<0.05 was considered statistically significant.Results:1.Comparison of general data:A total of 140 patients with cirrhotic ascites and hyponatremia in our hospital were collected,and the patients were divided into the experimental group and the control group by using a random number table and a random block design,with 70 cases in the experimental group and 70 cases in the control group.There was no significant difference in age,gender,etiology and Child-Pugh score between the two groups(P>0.05).2.Before treatment,there were no significant differences in blood sodium and potassium level between the experimental group and the control group(both P>0.05).After 2 consecutive weeks of treatment,the blood sodium level of the experimental group was higher than that of the same group before treatment(P<0.001),and higher than that of the control group,the difference was significant(P<0.05).After 2 consecutive weeks of treatment,there were no significant differences between the experimental group and the same group before treatment(P>0.05).3.Before treatment,there were no significant differences in ALT and blood creatinine between the experimental group and the control group(both P>0.05).After 2 consecutive weeks of treatment,there were no significant differences in ALT between the experimental group and the control group(P>0.05).After 2 consecutive weeks of treatment,there were no significant differences in blood creatine between the experimental group and the same group before treatment(P>0.05),and no significant differences compared with the control group(P>0.05).4.Before treatment,there were no significant differences in abdominal circumference,depth of ascites,and body weight between the experimental group and the control group(both P>0.05).After 2 consecutive weeks of treatment,the abdominal circumference,ascites depth and body weight of the experimental group decreased compared with the control group,the differences were significant(all P<0.05).5.Before treatment,there were no differences in systolic and diastolic blood pressure between the experimental group and the control group(both P>0.05).After treatment,there were no significant differences in systolic and diastolic blood pressure between the experimental group and the same group before treatment(both P>0.05),and no significant differences compared with the control group.6.During the treatment,the experimental group presented 11 patients with dry mouth symptoms,the control group presented 3 patients with dry mouth symptoms,and 5 patients with hypokalemia.After symptomatic treatment,the symptoms could be alleviated without any effect on the treatment.There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:1.Tolvaptan can effectively increase serum sodium level in patients with cirrhosis and hyponatremia,and can effectively reduce peritoneal effusion compared with traditional diuretics.In a short course of treatment,tolvaptan has no effect on liver function,kidney function,blood potassium level and blood pressure in patients with cirrhotic ascites and hyponatremia.2.Within a short course of treatment,the common adverse reactions of tolvaptan were thirst and dry mouth,which could be alleviated after symptomatic treatment.3.With its responding well as well as less adverse effect,tolvaptan is expected to be a better choice for the treatment of patients with cirrhotic ascites.