蔗糖铁联合促红细胞生成素治疗老年糖尿病患者慢性心衰合并贫血  

Effect of Correction of Anemia in Elderly Diabetics with Chronic Heart Failure by Subcutaneous Erythropoietin and Intravenous Iron Sucrose

作　　者：冯冰[1] 王浩[1] 沈元弟[1] 王琥[1] 王红娣[1] 唐静怡[1] 

机构地区：[1]中国人民解放军第四一一医院肾内科,上海市200081

出　　处：《医药论坛杂志》2009年第16期1-2,5,共3页Journal of Medical Forum

摘　　要：目的探讨蔗糖铁联合促红细胞生成素(EPO)治疗老年糖尿病患者慢性心功能不全(CHF)合并贫血的疗效和安全性。方法2006年1月-2008年8月,解放军第四一一医院肾内科共收治36例慢性心功能不全合并贫血老年糖尿病患者;其中男性21例,女性15例;年龄均>65岁,平均(74.2±5.8)岁;血红蛋白(Hb)均<120g/L。所有患者均静脉予以蔗糖铁(200mg/个月),皮下注射EPO(3000U/次,2次/周)治疗,共12个月。治疗前及治疗第6、12个月观测纽约心脏病协会(NYHA)心功能评分、左室射血分数(LVEF)、直视模拟标度尺(VAS)评分、Hb变化及不良反应发生情况并进行对比分析。结果到治疗第12个月,Hb从治疗前的(99.1±14.2)g/L上升至(128.0±12.5)g/L;NYHA分级从(3.9±1.3)级降至(2.7±0.4)级;LVEF从(31.6%±14.1%)上升至(41.0%±12.9%);VAS从(8.4±1.6)降至(2.6±1.9),以上各指标前后对比差异均有统计学意义(P<0.05)。治疗前后收缩压(SBP)、舒张压(DBP)、血肌酐(Scr)无明显改变。无药物不良反应及并发症发生。结论蔗糖铁静脉注射联合EPO治疗老年糖尿病患者慢性心功能不全合并贫血安全有效。Objective To investigate the efficacy of intravenous iron sucrose and subcutaneous erythropoietin in elderly diabetics with chronic heart failure and anemia. Methods Thirty - six elderly diabetics with chronic heart failure and anemia participated in the study,200 mg elemental iron was administered per month for 12 months,the EPO 3000 U was given twice a week. The efficacy was assessed by determining the subsequent changes in Hb, NYHA class, LVEF and VAS values during the treatment. Results This combination therapy led to a marked improvement in cardiac function,shortness of breath and fatigue, the Hb levels increased from （99. 1± 14.2） g/L to （128.0 ± 12.5） g/L, LVEF from （ 31.6% ±14. 1 ） % to （41.0% ± 12.9） %, P 〈 0. 05 ; Both the NYHA class and VAS levels were lower than that of pre - treatment. There were no obvious changes in blood pressure and Scr. Conclusion Intravenous iron sucrose and subcutaneous erythropoietin were effective and safe in treating anemia patients in elderly diabetics with chronic heart failure.

关 键 词：蔗糖铁 促红细胞生成素 贫血 治疗效果 

分 类 号：R973.3[医药卫生—药品]