促红细胞生成素对慢性心力衰竭合并贫血的临床疗效观察

目的探索促红细胞生成素（EPO）对慢性心力衰竭（CHF）合并贫血患者的临床疗效的影响。方法选入2012年1月—2014年1月在我院住院收治的101例CHF（NYHAⅡ-Ⅳ级）合并贫血的患者,采用数字随机法随机分为治疗组51例和对照组50例。治疗组在常规心力衰竭治疗基础上加用EFO皮下注射及口服铁剂治疗,对照组常规心力衰竭治疗及口服铁剂治疗。两组持续治疗6个月后（铁剂口服时间不超过3个月）,观察心功能NYHA分级、Nt-proBNP、心脏B超、血红蛋白（Hb）、6 min步行试验（6-MWT）、再入院率等指标。结果治疗6个月后,治疗组与对照组比较：心功能NYHA分级明显降低（P〈0.05）、Nt-proBNP明显降低（P〈0.01）、左室舒张末内径（LVDd）降低（P〈0.05）、左室射血分数（LVEF）明显升高（P〈0.01）、Hb明显升高（P〈0.01）、6-MWT距离明显增加（P〈0.01）、再入院率明显减少（P〈0.05）,差异均有统计学意义。结论联合使用EPO治疗CHF合并贫血患者可改善其心功能及运动耐量,降低心衰复发和加重的风险,改善预后,提高生活质量。

Observation on the Efficacy of Erythropoietin With Anemia of Chronic Ceart Failure

Objective To explore the effects of erythropoietin（EPO） for chronic heart failure（CHF） patients associated with anemia. Methods Elected to the January 2012 to January 2014 in 101 cases of CHF（NYHA Ⅱ-Ⅳ） with anemia in patients admitted to our hospital, the use of digital randomly divided into treatment group 51 cases and the control group of 50 patients. In the conventional treatment group, the treatment of heart failure based on the use EFO subcutaneous and oral iron therapy, group therapy and routine oral iron treatment of heart failure. Continued treatment groups after 6 months（oral iron no more than 3 months）.Observed NYHA class, Nt-proBNP, echocardiography, hemoglobin（Hb）, 6-minute walk test（6-MWT）, readmission rates and other indicators. Results After 6 months of treatment, the treatment group compared with control group： NYHA class was significantly lower（P〈0.05）, Nt-proBNP was significantly lower（P〈0.01）, left ventricular end diastolic diameter（LVDd） lower（P〈0.05）, left ventricular ejection fraction（LVEF） was significantly higher（P〈0.01）, Hb was significantly higher（P〈0.01） 6-MWT distance significantly increased（P〈0.01）,readmission rate was significantly reduced（P〈0.05）, differences were statistically significant. Conclusions In anemic patients with CHF, correction of anemia with EPO can improve cardiac function and exercise tolerance, reduce the risk of recurrence and worsening heart failure, improve quality of life and improve the prognosis.