促红细胞生成素联用参附注射液治疗慢性心力衰竭合并贫血的临床观察

目的观察促红细胞生成素（EPO）联合参附注射液治疗合并贫血的慢性心力衰竭（CHF）的临床疗效。方法将160例合并贫血的CHF患者随机分成4组：对照组（常规治疗组）、EPO组、参附注射液组和EPO加参附注射液组，每组各40例。记录治疗前、后各组患者的心功能分级（NYHA）、明尼苏达心衰生活质量评分、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、血浆N末端B型利钠肽原（NT-pro-BNP）水平及血红蛋白（Hb）浓度，统计再住院率，观察不良反应。结果治疗后各组患者的心功能分级和生活质量评分均明显下降，LVEF提高，LVEDD缩小，NT-pro-BNP水平降低，Hb浓度升高，而EPO组、参附注射液组和EPO加参附注射液组的疗效较对照组又有显著提高，再住院率显著低于对照组（尸〈0．05）。各组治疗后未见明显不良反应。结论EPO联合参附注射液治疗慢性心力衰竭合并贫血能显著提高临床疗效。

Clinical observation of erythropoietin and Shenfu injection in the treatment of patients with chronic heart failure and anemia

Objective To observe the clinical efficacy of erythropoietin（EPO） and Shenfu injection in the treatment of chronic heart failure（CHF） and anemia. Methods 160 patients with CHF and anemia were randomly divided into four groups, 40 patients in the control group were treated by standard CHF medication, 40 patients in the EPO group were treated by standard CHF medication plus EPO, 40 patients in the Shenfu injection group were treated by standard CHF medications plus Shenfu injection, 40 patients in the EPO and Shenfu injection group were treated by standard CHF medications plus EPO and Shenfu injection. The functional classification of heart failure, the Minnesota Heart Failure Quality of Life Scale, left ventricular ejection fraction （LVEF）, left ventricu- lar end-diastolic diameter （LVEDD） and serum N-terminal pro-brain natriuretic peptide （NT-pro-BNP） and hemoglobin （Hb） level were measured before and after treatment. The rate of re-hospitalization, eomplications and adverse events were observed. Results After treatment, functional classification and the Minnesota Heart Failure Quality of Life Scale decreased, LVEF increased, LVEDD decreased, serum NT-pro-BNP level decreased and Hb level increased in all groups. The change in the EPO group and the Shenfu Injection group and the EPO and Shen- fu injection group were superior to that in the control group （P〈0.05）, and the rate of re-hospitalization increased obviously in the control group （P〈0.05）. No important complications and adverse events occurred. Conclusion Treatment with EPO and Shenfu Injection can enhance the clinical effect in patients with CHF and anemia.