目的 观察托伐普坦联合利尿剂治疗对心力衰竭伴水潴留患者血钠水平及预后的影响。方法 将2014年3月-2015年6 月我院心内科92例心力衰竭伴水潴留患者随机分为对照组46例和观察组46例，对照组给予利尿剂等常规抗心衰治 疗，观察组给予托伐普坦联合利尿剂治疗，观察比较两组患者治疗前后血钠水平变化，并对比两组临床疗效及心血 管事件发生情况。结果 治疗前，两组患者血钠水平比较差异无统计学意义（P>0.05），治疗后，观察组血钠水平 明显高于对照组，差异有统计学意义（P<0.05）；观察治疗有效率（91.30%）明显高于对照组，且观察组心血管事 件发生率明显低于对照组，差异均有统计学意义（P<0.05）。结论 托伐普坦联合利尿剂治疗对心力衰竭伴水潴留 患者，升高血钠作用明显，可纠正电解质平衡，疗效显著，值得临床推广。

Objective To observe tolvaptan combined with diuretic treating heart failure with water retention patients in influencing serum sodium levels and the prognosis. Methods 92 cases of heart failure with water retention patients admitted and treated in our hospital during March 2014 and June 2015 were selected as the study objectives. They were randomly divided into contrast group and observation group with 46 cases in each group. Patients in the contrast group were given conventional anti-heart-failure treatment like diuretic, while patients in the observation group were given treatment of tolvaptan combined with diuretic. Observe the serum sodium levels changing of before and after treatment. Compare the clinical curative effects as well as the cardiovascular event occurrence condition between both groups. Results Before treatment, the comparison of serum sodium levels between both groups showed no statistical significance (P>0.05). After treatment, the serum sodium levels in the observation group were significantly higher than the contrast group. The difference showed a statistical significance (P<0.05). The total effective rate in the observation group (91.30%) was significantly higher than the contrast group. And the occurrence rate of cardiovascular event was obviously lower than the contrast group. The difference showed a statistical significance (P<0.05). Conclusion Tolvaptan combined with diuretic is proved to be effective in treating heart failure with water retention patients, which helps to increase the serum sodium levels and redress the electrolyte balance with significant curative effects. Thus, it deserves to be widely promoted in clinical field.