促红细胞生成素治疗老年慢性心力衰竭的临床疗效及安全性

Clinical study of therapeutic effects and safety of erythropoietin treatment for elderly patients with chronic heart failure

目的:探讨促红细胞生成素(EPO)对老年慢性心力衰竭(CHF)患者的临床疗效、心功能分级、运动耐量影响及毒副作用。方法:将80例CHF患者随机分成试药组(n=40)和对照组(n=40)。采用常规口服稳定剂量的利尿剂、地高辛、血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)、β受体阻滞剂等药物。试药组在对照组基础上皮下注射EPO 100 U/kg,每周1次,治疗6个月。结果:试药组EPO治疗前后相比心功能测定LVEF、6分钟步行距离、心肌耗氧量峰值、血红蛋白均有显著改善(P<0.05),组间比较贫血组较非贫血组显著改善(P<0.05)。结论:EPO能改善CHF患者的心功能状态和临床症状,并提高运动耐量,且与贫血状态改善有关。

AIM： To study the effect and safety of erythropoietin （EPO） in the treatment of chronic heart failure （CHF） in elderly patients. METHODS： Eighty patients with CHF were randomly divided into two groups. Patients in the control group （n = 40） were administered the routine treatment of CHF （diuretics, digoxin and ACEI）, whereas in addition to the routine treatment, patients in the study group （n = 40） were given a dose of EPO, 100 U/kg IH, once a week for 6 mouths. Left ventricular ejection fraction （LVEF） and hemoglobin （Hb） were measured, respectively, by echocardiography and laboratory examination. Heart function was examined by 6-min walking distance and NYHA heart function classification. RESULTS： Obvious improvements in LVEF, Hb, 6-min walking distance and NYHA heart function classification were observed in the study group after 6 months administration of EPO. The therapeutic effect was significantly different between groups （P 〈 0. 05 ）. CONCLUSION： EPO treatment is safe and effective for improving heart function and enhances exercise tolerance in CHF patients.