摘要
目的 探讨促红细胞生成素联合铁剂治疗慢性心力衰竭（CHF）合并贫血患者的疗效.方法 选择2007年1月至2009年12月我院连续住院治疗的CHF合并贫血患者96例,随机分为治疗组和对照组各48例,治疗组以常规抗心力衰竭治疗,加用促红细胞生成素及铁剂口服,对照组仅以常规抗心力衰竭治疗,随访6个月,比较2组治疗前后血红蛋白（Hb）水平、心功能分级、左心室射血分数（LVEF）、6 min步行距离、心力衰竭再入院率、心源性病死率等指标的变化.结果 治疗组患者与治疗前比较,Hb水平[（120.12±10.42）g/L与（86.40±14.30）g/L,t=-12.837,P＜0.01]、心功能分级（2.65±0.67与3.13±0.61,t=5.052,P＜0.01）、LVEF[（37.21±4.96）%与（33.92±7.28）%,t=-3.151,P＜0.01]、6 min步行距离[（443.52±97.39）m与（379.15±59.34）m,t=-4.262,P＜0.01]显著改善.随访6个月后,治疗组患者与对照组比较,Hb水平[（120.12±10.42）g/L与（85.60±11.22）g/L,t=16.083,P＜0.01]、心功能分级（2.65±0.67与2.98±0.81,t=-2.507,P＜0.05）、LVEF[（37.21±4.96）%与（34.67±4.10）%,t=-2.736,P＜0.01]、6 min步行距离[（443.52±97.39）m与（391.04±67.98）m,t=3.061,P＜0.01]显著优于对照组.心力衰竭再入院率显著下降（20.83%与39.58%,χ2=4.002,P＜0.05）,但2组病死率差异无统计学意义（0%与4.17%,χ2=2.043,P＞0.05）.结论 促红细胞生成素联合铁剂治疗CHF合并贫血可显著改善患者心功能指标,显著提高患者运动耐力,降低心力衰竭再住院率.
Objective To explore the therapeutic effect of erythropoietin （EPO）combined oral iron in patients with chronic congestive heart failure（ CHF）accompanied by anemia. Methods Ninety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin （ Hb ）, cardiac function classification, left ventricular ejection fraction（LVEF） ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. Results Compared with those before therapy, we found significant improvements of hemoglobin level （ [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P 〈 0. 01 ）, cardiac function classification （ 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P 〈 0. 01 ）, LVEF （ [ 37.21 ± 4. 96 ]% vs [ 33. 92 ± 7. 28 ]%, P 〈 0. 01 ）, 6-minute walking distance （ [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P 〈 0. 01 ） in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level （ [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P 〈 0. 01 ）, cardiac function classification （ 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P〈0.01）,LVEF（[37.21 ± 4.96]% vs [34.67 ±4.10]%,P 〈 0. 01）,6-minute walking distance （ [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P 〈 0. 01 ） in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control （20. 83% vs 39. 58% ,P 〈 0. 05 ）. However, we found no significant difference in cardiac death rate （ 0% vs 4. 17%, P 〉0. 05）. Conclusion Treatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure （CHF）accompanied by anemia.
出处
《中国综合临床》
2011年第1期35-37,共3页
Clinical Medicine of China
基金
南京市科技发展计划项目（200702079）
关键词
促红细胞生成素
铁剂
慢性心力衰竭
贫血
Erythropoietin
Oral iron
Chronic congestive heart failure
Anemia
