促红细胞生成素联合铁剂口服对慢性心力衰竭合并贫血患者的临床疗效

Clinical effect of erythropoietin combined with iron oral on the patients of chronic heart failure complicated with anemia

目的:分析促红细胞生成素联合铁剂口服对慢性心力衰竭合并患者的临床疗效。方法:纳入门诊、心内科内慢性心力衰竭伴有贫血的患者共86例。所有患者随机分为两组,每组各43例,对照组采用常规药物治疗,治疗组在常规治疗基础上给予促红细胞生成素3 000 U/次,2次/周,皮下注射,并口服富马酸亚铁颗粒0.1 g/次,3次/d,共用药1个月。根据输血指南结合患者情况必要时补充输注红细胞悬液。入组前及治疗3个月时进行纽约心功能分级评估、超声心动图检查心脏功能及血红蛋白、脑钠肽检测。比较两组临床疗效、两组患者血红蛋白、脑肭肽含量及心功能,记录两组患者1年内再住院率。结果:治疗组显效35例,有效7例,无效1例,总有效率为97.7%;对照组显效21例,有效13例,无效9例,总有效率为79.1%,两组总有效率比较,差异有统计学意义(P<0.05)。1年内两组再住院率比较,差异有统计学意义(P<0.05)。治疗组治疗后的血红蛋白含量明显增加、脑肭肽含量下降,与对照组治疗后比较,差异有统计学意义(P<0.05);治疗组治疗后的左室射血分数明显增加,与对照组治疗后比较,差异有统计学意义(P<0.05);治疗组治疗后的心功能指数明显增加,与对照组治疗后比较,差异有统计学意义(P<0.05)。结论:促红细胞生成素联合铁剂口服对慢性心力衰竭合并贫血患者有确切疗效。

Objective To analyze the effect of erythropoietin combined with oral iron on patients of chronic heart failure complicated with anemia.Method From January 2009 to January 2012 in our hospital,86 patients of chronic heart failure patients with anemia were included in the outpatient department of Cardiology.All patients were randomly divided into two groups,43 cases in each group.The control group were treated with conventional drug therapy,the treatment group were treated with erythropoietin 3 000 U/ times subcutaneous injection and oral ferrous fumarate granules0.1 grams / time on the basis of routine treatment for one month.According to the transfusion guide,transfusing red cells suspension was given.The heart function was assessed,and hemoglobin,brain natriuretic peptide were tested.Results The total effective rate of the treatment group was 97.7%;the control group was 79.1%,the total effective rate of two groups had significant difference（P0.05）.Rehospitalization rate of the two groups for 1 year were significantly different（P0.05）.After treatment,hemoglobin content of the treatment group was significantly increased,BNP was decreased,and there was significant differences when compared these two groups（P0.05）;compared the effect of treatment,left ventricular ejection fraction of the treatment group increased significantly,and there was significant differences between these two groups（P0.05）;After treatment,the cardiac function index of the treatment group increased obviously,and the comparison of the two groups,there was significant differences（P0.05）.Conclusion Combination of erythropoietin in chronic heart failure and oral iron in patients with anemia has exact curative effect.