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目的 比较托伐普坦片和呋塞米注射液治疗心力衰竭伴收缩功能障碍的临床疗效及安全性.方法 将104例心力衰竭伴收缩功能障碍患者随机分为对照组49例和试验组55例.对照组予以呋塞米每次40 mg,qd,静脉推注;试验组予以托伐普坦每次15 mg,qd,口服.2组患者均治疗5 d.比较2组患者的临床疗效、心率、肺动脉压、肺毛细血管压和心排血量,以及药物不良反应的发生情况.结果 治疗后,试验组和对照组的总有效率分别为89. 09％(49例/55例)和71. 43％(35例/49例),差异有统计学意义(P <0. 05).治疗后,试验组和对照组的心率分别为(80. 15±10. 04)和(84. 71±9. 66)次/分,肺动脉压分别为(21. 85±4. 49)和(28. 47±4. 46)mm Hg,肺毛细血管压分别为(11. 24±1. 61)和(15. 18±2. 76)mm Hg,心排血量分别为(1. 94±0. 30)和(2. 16±0. 25)L·min-1·m-2,差异均有统计学意义(均P 0. 05).结论 托伐普坦片治疗心力衰竭伴收缩功能障碍的临床疗效确切,其能够有效地改善患者的心率、肺动脉压、肺毛细血管压和心排血量,且不增加药物不良反应的发生率.“,”Objective To compare the clinical efficacy and safety of tolvaptan tablets and furosemide injection in the treatment of heart failure with systolic dysfunction. Methods One hundred and four patients of heart failure with systolic dysfunction were randomly divided into control group (n = 49 cases) and treatment group (n = 55 cases) . Control group received furosemide 40 mg per time, qd, intravenous bolus. Treatment group received tolvaptan 15 mg per time, qd, orally. The clinical efficacy, heart rate, pulmonary artery pressure, pulmonary capillary pressure and cardiac output, and adverse drug reactions were compared between two groups. Results After treatment, the total effective rates of treatment and control groups were 89. 09％ (49 cases/55 cases) and71. 43％ (35 cases/49 cases) with significant difference (P < 0. 05) .After treatment, the main indexes of treatment and control groups were compared: heart rates were (80. 15 ± 10. 04) and (84. 71 ± 9. 66) beat·min-1, pulmonary artery pressure were (21. 85 ± 4. 49) and (28. 47 ± 4. 46) mm Hg, pulmonary capillary pressure were (11. 24 ± 1. 61) and (15. 18 ± 2. 76) mm Hg, cardiac output were (1. 94 ± 0. 30) and (2. 16 ± 0. 25) L · min-1· m-2, the differences were statistically significant (all P 0. 05) . Conclusion Tolvaptan tablets have a definitive clinical efficacy in the treatment of heart failure with systolic dysfunction, which can effectively improve the heart rate, pulmonary artery pressure, pulmonary capillary pressure and cardiac output, without increasing the incidence of adverse drug reactions.