治疗慢性心力衰竭患者贫血对改善心功能作用的研究  

Treatment of the anemia in chronic heart failure patients improve the cardiac function

作　　者：李正恭[1] 吴文利[1] 王骄[1] 张敏[1] 

机构地区：[1]重庆市中山医院心内科,400013

出　　处：《重庆医学》2005年第4期523-524,共2页Chongqing medicine

摘　　要：目的慢性充血性心功能衰竭患者常合并贫血,观察常规药物治疗基础上同时纠正贫血后是否能促进心功能改善.方法筛选临床心功能NYHAⅢ及Ⅳ级、不伴有异位心律、血色素低于120g/L的患者,随机分成对照组50例,年龄(57.6±7.3)岁,女/男(51.06/48.94)%与治疗组48例,年龄(58.1±7.8)岁,女/男(51.1/48.9)%.两组均以常规药物治疗,如:洋地黄、利尿剂、血管扩张剂与ACEI等,但治疗组增加皮下注射重组人红细胞生成素及口服硫酸亚铁丸.利用超声心动图分别在治疗初1～2d及治疗后1个月测定心功能(EF%).数据统计采用t检验.结果两组各3例失随访,对照组与治疗组心功能分别为:治疗前(36.063±2.015)%与(35.193±2.42)%(P=0.145),治疗后(41.196±2.608)%与(52.64±3.476)%(P=0.095),有统计学意义,且两组治疗后心功能的绝对增加值为(14.374±9.826)%与(21.917±12.148)%(P=0.017),也有显著差异.血色素低于90g/L者,对照组(18例)心功能由(34.137±4.03)%升至(38.045±3.17)%,治疗组(19例)心功能由(33.764±3.24)%升至(57.381±5.446)%,两组心功能增加值比较有显著差异(P＜0.001).对照组与治疗组心功能治疗前、后同组对照有显著意义(P＜0.001).结论对合并贫血的慢性心功能衰竭患者,治疗心功能不全的同时治疗贫血有助于心功能的进一步改善,但远期效果待观察.s:Objective Anemia is common in the patients of severe chronic congestive heart failure. We treated the anemia and observed if it was helpful for the improving of cardiac function.Methods We selected the patients as the cardiac function were NYHA class Ⅲ and Ⅳ,with no marked arrhythmia such as atrial fibrillation or artificial pacing,and hemoglobin lower than 120g/L.We divided the patients into two groups randomly: control group (n=50),(57.6±7.3) years of age, female/male was (51.06/ 48.94 )% and treatment group (n=48),(58.1±7.8),(51.1/ 48.9 )%.Both groups were treated with routine medicine generally which included digoxin, diuretics and an ACE inhibitor, but for the treatment group we added subcutaneous recombinant human erythropoietin 2000 IU/week and oral Fe sulfate. We measured the cardiac function (EF%) under echocardiogram at the 1st or 2nd day of the beginning of treatment and 1 month later, and used t-test for the data statistics.Results Both groups had 3 cases lost in follow-up. EF% before treatment: the control group was (36.063±2.015)%,the treatment group was (35.193±2.42)% (P= 0.145 ,NS);after treatment:(41.196±2.608)% and (52.64±3.476)%(P<0.001),and the absolute increased volumes were ( 14.374 ±9.826)% and(21.917±12.148)% respectively (p=0.017),which had statistic significance. The cases of hemoglobin lower than 90g/L, increased volume of EF%: the control group was (34.137±4.03)% up to (38.045±3.17)%, the treatment group was (33.764±3.24)% up to (57.381±5.446)%,had statistic significance(P<0.001). All groups had their cardiac function improved (P<0.001) after treatment.Conclusion The treatment of anemia should improve the cardiac function in chronic heart failure patients.

关 键 词：慢性心功能衰竭 贫血 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]