肝硬変患者におけるトルバプタンの効果と長期予後についての検討
| Jazyk: | japonština |
|---|---|
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | 山形大学紀要. 医学 : 山形医学. 38(2):69-74 |
| ISSN: | 0288-030X |
| Popis: | 論文(Article) Subjects: Spironolactone and furosemide are commonly used for treatment of hepatic ascites, but the vasopressin V2 receptor inhibitor tolvaptan may also be added in cases that are treatment-resistant. The present study was conducted to clarify the factors affecting the therapeutic effectiveness of tolvaptan. Methods: We studied 65 patients who were admitted to our hospital between September 2013 and September 2018. Patients whose weight decreased by 1.5 kg or more one week after tolvaptan administration were defined as responders（R）, and compared with non-responders（NR）. Results: The two groups were compared in terms of age, cause of liver cirrhosis, presence of esophageal varices, presence of hepatocellular carcinoma, dose of furosemide, dose of spironolactone, albumin, T-bilirubin, PT%, and creatinine. Serum Na levels were significantly higher in R patients with significantly lower BUN. R patients survived significantly longer than NR patients. There was significant difference in survival rate between patients with a Na level of 138 mEq/L or less than for those with a Na level of 139 mEq/L or more. The main factor related to good treatment responsiveness in patients receiving tolvaptan was absence of any decrease in serum Na and a stable BUN level. Conclusion: The factors related to the effectiveness of tolvaptan for treatment of ascites are a decrease in Na and an increase in BUN. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|