Liu Yu-Hong, Han Xiao-Bo, Fei Yue-Hai, Xu Hong-Tao
Department of General Internal Medicine and Geriatric Critical Care, Navy General Hospital PLA, Beijing, China.
Medicine (Baltimore). 2017 Dec;96(52):e9539. doi: 10.1097/MD.0000000000009539.
The retrospective study aimed at investigating the safety and clinical efficacy of long-term application of tolvaptan in patients >90 years old with hyponatremia. Although tolvaptan has been used to treat hyponatremia, the effect of its long-term use in elderly patients was unknown.Seven patients over 90 with isovolumic or hypervolemic hyponatremia admitted to the PLA Navy General Hospital between October 2011 and October 2013 were enrolled. The patients' serum sodium levels <135 mmol/L persisted for more than 3 months, and oral treatment with tolvaptan lasted for more than 12 months. Tolvaptan dose started from 7.5 mg once daily, with maximum dose no more than 30 mg daily. Clinical and laboratory data of the patients before and after treatment were compared.Serum sodium and chlorine levels increased significantly in the 1st 3 days after treatment (P < .05). All patients' serum sodium levels were above 135 mmol/L 1 month after treatment, and sustained through 1 year after treatment, without extra sodium supplementation. No serious complications were observed.The result indicated a significant improvement in the serum sodium levels and no serious adverse effects after long-term use in very elderly patients.
这项回顾性研究旨在调查长期应用托伐普坦治疗90岁以上低钠血症患者的安全性和临床疗效。尽管托伐普坦已被用于治疗低钠血症，但其在老年患者中的长期使用效果尚不清楚。选取2011年10月至2013年10月期间入住解放军海军总医院的7例90岁以上等容性或高容性低钠血症患者。患者血清钠水平<135 mmol/L持续超过3个月，口服托伐普坦治疗持续超过12个月。托伐普坦剂量从每日7.5 mg开始，最大剂量不超过每日30 mg。比较患者治疗前后的临床和实验室数据。治疗后第1个3天血清钠和氯水平显著升高（P<0.05）。所有患者治疗1个月后血清钠水平均高于135 mmol/L，并持续至治疗后1年，无需额外补充钠。未观察到严重并发症。结果表明，在高龄患者中长期使用后血清钠水平有显著改善且无严重不良反应。
