促红细胞生成素联用参附注射液治疗慢性心力衰竭的疗效观察

目的 观察促红细胞生成素（erythropoietin,EPO）联合参附注射液治疗慢性心力衰竭（chronic heart failure,CHF）的临床疗效.方法 将160例CHF患者随机分成对照组（n=40）、EPO组（n=40）、参附注射液组（参附组,n=40）和EPO联合参附注射液组（EPO＋参附组,n=40）,比较治疗前后各组患者的心功能分级（NYHA）和明尼苏达心力衰竭生活质量评分、左心室射血分数（left ventricular ejection fraction,LVEF）、左心室舒张末期内径（left ventricular end-diastolic diameter,LVEDD）、血浆N末端脑钠肽前体（NT-proBNP）水平、再住院率,不良反应发生情况.结果 治疗后4组心功能均得到了提高,以EPO＋参附组改善最为明显,心功能评级由（3.7±0.47）降至（1.2±0.52）,生活质量评分由（46.5±1.41）降为（22.1±2.53）,同时NT-proBNP水平均也由治疗前（2712.2±323.30）ng/L降至（352.0±60.52）ng/L,LVEF由（31.3±2.88）%升至（48.1±5.21）%,LVEDD由（67.1±2.35）mm降至（52.1±3.33）mm,再入院率为35.0%,均低于其他三组.结论 EPO联合参附注射液治疗慢性心力衰竭能明显改善心功能、提高生活质量和降低再住院率,显著提高临床疗效.

Treatment of chronic heart failure with erythropoietin combining Shenfu Injection

Objective To observe the curative effect of erythropoietin （EPO） combining Shenfu Injection on chronic heart failure （CHF）. Methods The patients with CHF （n=160） were randomly divided into control group （routine treatment）, EPO group, Shenfu Injection group and EPO combining Shenfu Injection group （combining group, each n=40）. The scores of NYHA and Minnesota Heart Failure Quality of Life Scale, LVEF, LVEDD and NT-pro-BNP were recorded in all groups before and after treatment. The rate of re-hospitalization and adverse reactions were observed. Results The heart function was improved in all four groups and was more. significant in combining group. To EPO ＋ Shenfu group improved most obviously, the degree of cardiac function decreased from （3.7 ±0.47） to （1.2 ± 0.52）, quality of life scores decreased from the （46.5 ± 1.41） to （22.1 ± 2.53）, while NT- proBNP levels were also decreased from （2712.2 ± 323.30）ng/L to （352.0 ± 60.52）ng/L, LVEF increased from （31.3 ± 2.88）% to （48.1 ± 5.21）%, LVEDD decreased from （67.1 ± 2.35） mm to （52.1 ± 3.33） mm., and the readmission was 35.0%, which was lower than other three groups. Conclusion EPO combining Shenfu Injection can significantly improve the heart function, promote the quality of life, reduce the rate of re-hospitalization, and enhance curative effect.