抗贫血治疗对慢性充血性心功能衰竭合并贫血患者心功能的影响研究

Effect of Anti-Anemia Treatment on the Cardiac Function of Patients with Chronic Congestive Heart Failure Complicated with Anemia

目的探讨抗贫血药物治疗对改善慢性充血性心功能衰竭合并贫血患者心功能的效果。方法选取我院自2012年7月至2014年6月收治的慢性充血性心功能衰竭合并贫血患者46例,随机分为两组各23例,对照组给予慢性充血性心功能衰竭常规治疗,包括血管紧张素受体拮抗剂(ARB)或血管紧张素转换酶抑制剂(ACEI)、β受体阻滞剂、利尿剂、洋地黄类药物等,观察组在此基础上给予促红细胞生成素及铁剂,观察并比较两组治疗前后的心功能分级、血红蛋白(HGB)水平、血浆脑钠肽(BNP)水平、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、6 min步行距离。结果两组治疗后心功能分级较同组治疗前显著改善(P<0.05),且观察组治疗后的心功能分级、LVEF显著优于对照组(P<0.05),两组治疗前后的LVEDD相比差异无统计学意义(P>0.05)。两组治疗后的BNP水平、HGB水平、6 min步行距离均较同组治疗前显著改善(P<0.05),且观察组治疗后各项指标均显著优于对照组(P<0.05)。结论慢性充血性心功能衰竭患者在常规治疗的基础上应用抗贫血药物可有效提高患者的心功能,改善患者预后,值得在临床上推广。

Objective To explore the effect of anti-anemia drug treatment to improve the cardiac function of patients with chronic congestive heart failure complicated with anemia. Methods A total of 46 patients with chronic congestive heart failure complicated with anemia admitted to our hospital from July 2012 to June 2014 were selected and randomly divided into the control group and the observation group equally. All patients received routine therapy of chronic congestive heart failure, including angiotensin receptor blocker （ARB） or angiotensin converting enzyme inhibitors （ACEI）,β-blockers, diuretics and digitalis drugs; in addition, the observation group received erythropoietin and ferralia. The cardiac function classification, hemoglobin （HGB） level, brain natriuretic peptide （BNP） level, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, and 6-minute walking distance before and after treatment were compared between two groups. Results After treatment, the cardiac fimction classification of both groups improved significantly （P〈0.05）, and the observation group was superior to the control group in the cardiac function classification and LVEF （P〈0.05）; No statistical difference was found in the LVEDD before and after treatment between two groups （P〉0.05）. After treatment, the BNP level, HGB level and 6-minute walking distance improved significantly in both groups, and the observation group had more significant improvement compared with control group （P〈0.05）. Conclusions Anti-anemia drug treatment combined with routine therapy for patients with chronic congestive heart failure complicated with anemia can effectively improve patients＇ cardiac function, and improve patients＇ prognosis, which is worthy of promotion in clinic.