CAJ | 학술논문

目的探讨促红细胞生成素联合铁剂治疗慢性心力衰竭(CHF)合并贫血患者的疗效.方法选择2007年1月至2009年12月我院连续住院治疗的CHF合并贫血患者96例,随机分为治疗组和对照组各48例,治疗组以常规抗心力衰竭治疗,加用促红细胞生成素及铁剂口服,对照组仅以常规抗心力衰竭治疗,随访6个月,比较2组治疗前后血红蛋白(Hb)水平、心功能分级、左心室射血分数(LVEF)、6 min步行距离、心力衰竭再入院率、心源性病死率等指标的变化.结果治疗组患者与治疗前比较,Hb水平[(120.12±10.42)g/L与(86.40±14.30)g/L,t=-12.837,P＜0.01]、心功能分级(2.65±0.67与3.13±0.61,t=5.052,P＜0.01)、LVEF[(37.21±4.96)%与(33.92±7.28)%,t=-3.151,P＜0.01]、6 min步行距离[(443.52±97.39)m与(379.15±59.34)m,t=-4.262,P＜0.01]显著改善.随访6个月后,治疗组患者与对照组比较,Hb水平[(120.12±10.42)g/L与(85.60±11.22)g/L,t=16.083,P＜0.01]、心功能分级(2.65±0.67与2.98±0.81,t=-2.507,P＜0.05)、LVEF[(37.21±4.96)%与(34.67±4.10)%,t=-2.736,P＜0.01]、6 min步行距离[(443.52±97.39)m与(391.04±67.98)m,t=3.061,P＜0.01]显著优于对照组.心力衰竭再入院率显著下降(20.83%与39.58%,χ2=4.002,P＜0.05),但2组病死率差异无统计学意义(0%与4.17%,χ2=2.043,P＞0.05).结论促红细胞生成素联合铁剂治疗CHF合并贫血可显著改善患者心功能指标,显著提高患者运动耐力,降低心力衰竭再住院率.
목적 탐토촉홍세포생성소연합철제치료만성심력쇠갈(CHF)합병빈혈환자적료효.방법 선택2007년1월지2009년12월아원련속주원치료적CHF합병빈혈환자96례,수궤분위치료조화대조조각48례,치료조이상규항심력쇠갈치료,가용촉홍세포생성소급철제구복,대조조부이상규항심력쇠갈치료,수방6개월,비교2조치료전후혈홍단백(Hb)수평、심공능분급、좌심실사혈분수(LVEF)、6 min보행거리、심력쇠갈재입원솔、심원성병사솔등지표적변화.결과 치료조환자여치료전비교,Hb수평[(120.12±10.42)g/L여(86.40±14.30)g/L,t=-12.837,P＜0.01]、심공능분급(2.65±0.67여3.13±0.61,t=5.052,P＜0.01)、LVEF[(37.21±4.96)%여(33.92±7.28)%,t=-3.151,P＜0.01]、6 min보행거리[(443.52±97.39)m여(379.15±59.34)m,t=-4.262,P＜0.01]현저개선.수방6개월후,치료조환자여대조조비교,Hb수평[(120.12±10.42)g/L여(85.60±11.22)g/L,t=16.083,P＜0.01]、심공능분급(2.65±0.67여2.98±0.81,t=-2.507,P＜0.05)、LVEF[(37.21±4.96)%여(34.67±4.10)%,t=-2.736,P＜0.01]、6 min보행거리[(443.52±97.39)m여(391.04±67.98)m,t=3.061,P＜0.01]현저우우대조조.심력쇠갈재입원솔현저하강(20.83%여39.58%,χ2=4.002,P＜0.05),단2조병사솔차이무통계학의의(0%여4.17%,χ2=2.043,P＞0.05).결론 촉홍세포생성소연합철제치료CHF합병빈혈가현저개선환자심공능지표,현저제고환자운동내력,강저심력쇠갈재주원솔.
Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. Methods Ninety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. Results Compared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). Conclusion Treatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.