内源性促红细胞生成素在不同阶段慢性心衰患者中的变化与临床意义  

The changes and clinical significance of endogenous erythropoietin in different stages of chronic heart failure

作　　者：隋春兴[1] 郑晓群[1] 

机构地区：[1]大连市中心医院心内四科,辽宁大连116033

出　　处：《中国实验诊断学》2015年第7期1074-1077,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的观察内源性促细胞生成素(EPO)在慢性心力衰竭(CHF)患者不同临床阶段的血浆水平变化及临床意义。方法慢性心力衰竭患者114例数,其中NYHAⅢ患者38例,NYHAⅣa患者40例,NYHAⅣb患者36例。采用放射性免疫分析方法测定全部患者血浆EPO水平,同时检测NTproBNP、SCr及Hb浓度、估测GFR、随访90天内再住院率;分析不同阶段患者血浆EPO水平变化与患者贫血、慢性肾功能不全的关系。结果与其他两组相比较,NYHAⅣa组病人EPO水平更高差异有统计学意义(P<0.05);贫血、合并肾功能不全患者数量高于NYHAⅢ组患者数量,但无统计学差异(P>0.05);贫血及合并肾功能不全患者数量明显低于NYHAⅣb组,差异有统计学意义(P<0.05);NYHAⅣb组患者EPO水平低于NYHAⅣa组,差异有统计学意义(P<0.05);与NYHAⅢ组比较无统计学差异。90天再住院率NYHAⅣb组明显高于其他两组(P<0.05)。结论 CHF患者内源性EPO水平呈动态变化,但与CHF患者临床严重程度并不完全相关;与其他临床阶段患者比较,NYHAⅣb级的难治性心衰患者内源性EPO呈下降趋势,提示EPO相对生成不足及预示病人的临床程度恶化。Objective To observe the change and clinical significance of endogenous erythropoietin（EPO）levels in different clinical stages of patients with chronic heart failure.Methods The study enrolled 114 patients with chronic heart failure,including 38 cases with NYHA Ⅲ grade,40 cases with NYHA Ⅳagrade,36 patients with NYHA Ⅳb grade.Using radioimmunoassay method for measure of serum EPO level in all patients,while detecting NTproBNP,concentration of SCr and Hb and estimateing GFR,following-up 90 days of rerehospitalization rates;The relationship of serum EPO level change and the patients with anemia and chronic renal insufficiency were analyzed in patients with different clinical stages.Results Compared with the other two groups,EPO level is higher in patients with NYHA Ⅳa group,the difference was statistically significant（P〈0.05）;the number of Anemia,renal insufficiency cases is higher than NYHA Ⅲ group,but no statistical difference（P〉0.05）;compared with NYHA Ⅳb group,the number of Anemia and renal insufficiency cases obviously lower,the difference was statistically significant（P〈0.05）;In NYHA Ⅳb group,EPO level is lower than the other two groups（P〈0.05）;rehospitalization rates in 90 days is significantly higher than the other two groups in NYHA Ⅳb group（P〈0.05）.Conclusion Endogenous EPO levels showed dynamic changes in the patients with CHF,but it is not entirely related to clinical severity;In patients with NYHA Ⅳb grade endogenous EPO had a downward trend,suggesting that insufficient EPO generation indicates clinical deterioration.

关 键 词：慢性心力衰竭 促红细胞生成素 肾功能 贫血 

分 类 号：R541.6[医药卫生—心血管疾病]