促红细胞生成素在慢性心力衰竭的临床应用及机制研究进展

促红细胞生成素是特异性作用于红系祖细胞的造血生长因子，但新近有证据表明，促红细胞生成素具有重要的心脏保护功能。动物实验显示：促红细胞生成素能改善左心室功能，促红细胞生成素能明显降低心肌细胞凋亡，促红细胞生成素能抑制血管内皮细胞发生凋亡，刺激内皮前体细胞有丝分裂，使用促红细胞生成素治疗合并贫血的慢性心力衰竭患者，可显著改善患者的心功能及临床症状。临床研究表明促红细胞生成素可明显提高慢性心力衰竭合并贫血患者的血红蛋白浓度，改善心功能，提高运动耐量，尽管促红细胞生成素在治疗肾性贫血过程中可能有导致血压增高、血栓形成的危险，但促红细胞生成素治疗心肌缺血和慢性心力衰竭是安全的。目前，对促红细胞生成素的应用，有可能开辟治疗慢性心力衰竭的新途径。但促红细胞生成素用于慢性心力衰竭的预后的影响还需在经过精确设计的前瞻性研究中进行检测，其长期治疗心脏的不良反应有待进一步探讨及促红细胞生成素起始治疗时间、选用以及血红蛋白浓度的靶目标也尚需进一步探讨。其作用机制尚待进一步探讨。

Erythropoietin in Chronic Heart Failure andProgress in Its Clinical Application

Erythropoietin （EPO） is a hormone produced in the kidneys that promotes the growth of red blood cells. Recent evidence, however, indicates that EPO is also important in protecting heart function. Animal experiments showed that EPO can improve left ventricular function, EPO can significantly reduce myocardial apoptosis, EPO can inhibit vascular endothelial cells apoptosis, and stimulate endothelial precursor cell mitosis. Clinical studies show that EPO may improve anemia in patients with CHF merger of the concentration of hemoglobin （ Hb ） , improve heart function, improve exercise tolerance, although EPO in the treatment of renal anemia in the process may have led to increased blood pressure, blood tying the formation of dangerous, but for EPO Myocardial ischemia and CHF is safe. At present, the application of EPO as the treatment of CHF may open new avenues. EPO for chronic heart failure but the prognosis of the precision needed in the design of a prospective study of the test, the heart of its long-term treatment of adverse reactions to be further explored, and initial treatment of EPO, and the choice of target hemoglobin concentration of goal still needs to have further investigation.