人重组促红细胞生成素联合铁剂治疗慢性心力衰竭合并贫血患者187例疗效观察  

Clinical Research of Erythropoietin and Ferrous Object in 187 Patients of Chronic Congestive Heart Failure with Anemia

作　　者：姜小飞[1,2] 叶芬[1,2] 陈曦[1,2] 石理[1,2] 

机构地区：[1]暨南大学附属珠海医院 [2]珠海市人民医院心内科,广东珠海519000

出　　处：《四川医学》2015年第5期665-668,共4页Sichuan Medical Journal

摘　　要：目的探讨使用人重组促红细胞生成素(EPO)加铁剂治疗慢性心力衰竭(CHF)合并贫血患者的临床疗效。方法纳入在2007至2014年我院门诊及住院部治疗的CHF合并贫血的患者187例,随机分为单纯铁剂组(62例)、单纯EPO组(62例)及联合治疗组(63例)。单纯铁剂组予以口服铁剂(力蜚能0.15g/次,1次/d);单纯EPO组予以皮下注射EPO 2000U/次,3次/周;联合治疗组予以皮下注射EPO 2000U/次,3次/周,同时口服力蜚能0.15g/次,1次/d。共治疗6个月,观察治疗前、治疗后及随访12月时血红蛋白(Hgb)、B型脑利钠肽(BNP)、左室射血分数(LVEF)、左室舒张末内径(LVDd)、6分钟步行距离(6-MWD)等指标,并随访观察不良反应。结果相比较治疗前,三组患者在治疗后以及随访1年后,Hgb增加,LVDd缩小,LVEF增加,心功能分级与6-MWD改善,同时血浆中BNP水平下降,差异有统计学意义(P<0.05)。联合治疗组治疗后较单纯EPO组及铁剂组,在Hgb的升高、LVDd的减少,LVEF的增加及6-MWD的提高方面差异有统计学意义(P<0.05)。结论 EPO加口服铁剂治疗CHF并贫血患者,能改善患者的心脏结构与功能,降低BNP水平。Objective To explore the applied effectiveness of Erythropoietin（EPO） in Chronic Congestive Heart Failure （CHF） with anemia. Methods 187 patients CHF with anemia were divided at random into three groups： Ferrous group （62cases） , EPO group （ 62cases ） , Combine group （ 63cases ） o Ferrous were given to the ferrous group ; EPO were given to the EPO group. EPO and ferrous were given to the treatment group, and the duration of therapy was 6 months. Hemoglobin, B-type natriuretic peptide（BNP） ,left ventricle ejection fraction （LVEF）, diameter of diastolic left ventricle （LvDd）, 6 minute walking distance （6-MWD）, heart function（ NYHA functional class）were measured before and after therapy immediately and 12 months later. Re- suits After therapy for six months and follow up for 12 months, the level of Hemoglobin, LVEF and 6-MWD were increased, and BNP, NYHA functional class and LVDd were significant decreased after the therapy in all the groups （ all P 〈 0. 05 ）. All the inde- xes of Combine group were significant changed compared to other two groups （P 〈 0. 05）. Conclusion On basis of regular treat- ment of anti heart failure, intervention with EPO and ferrous against anemia could decrease the level of BNP and improve heart function of CHF with anemia.

关 键 词：充血性心力衰竭 贫血 促红细胞生长素 铁剂 

分 类 号：R541.6[医药卫生—心血管疾病]