促红细胞生成素联合铁剂治疗慢性心力衰竭合并贫血的临床观察  

OBSERVATION ON THE EFFECTS OF ERYTHROPOIETIN IN PATIENTS WITH CONGESTIVE HEART FAILURE ACCOMPANIED BY ANEMIA

作　　者：李艳[1] 曾智[2] 石卫晨[1] 林琦[1] 兰永乔[1] 陈兵阳[1] 

机构地区：[1]成都市第七人民医院,成都610041 [2]四川大学华西医院

出　　处：《现代预防医学》2010年第19期3768-3770,共3页Modern Preventive Medicine

摘　　要：[目的]探讨促红细胞生成素(EPO)联合口服铁剂治疗对老年慢性心力衰竭(CHF)合并贫血患者心功能的影响。[方法]采用病例对照研究,选择2007年11月～2009年1月间住院的慢性心力衰竭(NYHA心功能Ⅲ～Ⅳ级)合并贫血(血红蛋白﹤110g/L)患者63例随机分为治疗组和对照组。两组患者均予常规抗心衰治疗,治疗组予EPO皮下注射加口服铁剂,对照组予0.9%NS2ml皮下注射加口服铁剂。治疗4个月后观察血红蛋白,心功能,B型脑钠肽(BNP),左室射血分数(LVEF),左室舒张末内径(LVDd),6分步行距离(6-MWD)等指标。[结果]治疗组与对照组相比,相对基础状态血红蛋白明显增加(P﹤0.01),BNP明显下降(P﹤0.01),左室舒张末内径降低(P﹤0.05),左室射血分数增加(P﹤0.01),心功能改善(P﹤0.01)。治疗后两组患者血红蛋白、BNP、LVEF、6分步行距离、纽约心功能分级等指标差异有统计学意义。[结论]EPO联合铁剂治疗慢性心力衰竭患者能纠正贫血,改善患者的心功能。[Objective] To investigate the effects of erythropoietin（EPO） and oral iron in old patients with serious congestive heart failure（CHF） accompanied by anemia. [Methods] Sixty-three patients with serious CHF（New York Heart Association [NYHA] III or IV） accompanied by anemia were studied,hospitalized between 2007 November and 2009 January,and divided randomly into treatment group and control group. Both groups received regular anti-heart failure treatment and oral iron. The treatment group was added injection of EPO;while the control group was added injection of saline as the placebo. After four months follow-up,differences in objective indices were compared. [ Results] The patients in the treatment group demonstrated an increase in LVEF and the levels of Hb,significant reductions in plasma BNP and LVDd,significant improvement in NYHA functional class with respect to baseline. Compared with the control group,the treatment group had lower BNP and higher LVEF after four months follow-up. [Conclusion] In anemic patients with CHF,correction of anemia with EPO and oral iron leads to an improvement in the level of Hb and the cardiac function,compared with the control group in which only oral iron is used.

关 键 词：慢性心力衰竭 促红细胞生成素 贫血 

分 类 号：R541.6[医药卫生—心血管疾病]