CAJ | 학술논문

目的：研究促红细胞生成素联合铁剂对慢性心力衰竭合并贫血患者红细胞分布宽度（RDW）的影响。方法选取慢性心力衰竭合并贫血患者148例，采用数字表法随机分为治疗组和对照组各74例。两组患者均接受规范化抗心衰治疗，治疗组在对照组基础上予促红细胞生成素和铁剂治疗。测定两组治疗前后 RDW 的变化，分析 RDW 与其他检测指标的相关性。结果治疗组治疗后 RDW 为（13．08±0．792）％，明显低于对照组的（14．32±0．864）％（t ＝－8．974，P ＜0．01）。治疗组治疗前 RDW 与 N 末端脑钠肽前体（NT-proBNP）、超敏 C-反应蛋白（hs-CRP）呈正相关（r ＝0．783，P ＜0．01；r ＝0．870，P ＜0．01），与肌酐、血红蛋白呈负相关（r ＝－0．338，P ＜0．01；r ＝－0．743，P ＜0．01）。治疗组治疗前后 RDW 差值与 NT-proBNP、hs-CRP 差值呈正相关（r ＝0．783，P ＜0．01；r ＝0．680，P ＜0．01），与血红蛋白差值呈负相关（r ＝－0．459，P ＜0．01），与肌酐、尿酸、LDL、胆固醇、甘油三酯、LVEF 差值无明显相关性。结论促红细胞生成素联合铁剂能有效改善慢性心力衰竭合并贫血患者心功能，纠正贫血，降低 RDW 水平。RDW 水平与慢性心力衰竭合并贫血患者病情的严重程度呈正相关，可作为慢性心力衰竭合并贫血的患者病情评估及疗效判断的观察指标之一。
목적：연구촉홍세포생성소연합철제대만성심력쇠갈합병빈혈환자홍세포분포관도（RDW）적영향。방법선취만성심력쇠갈합병빈혈환자148례，채용수자표법수궤분위치료조화대조조각74례。량조환자균접수규범화항심쇠치료，치료조재대조조기출상여촉홍세포생성소화철제치료。측정량조치료전후 RDW 적변화，분석 RDW 여기타검측지표적상관성。결과치료조치료후 RDW 위（13．08±0．792）％，명현저우대조조적（14．32±0．864）％（t ＝－8．974，P ＜0．01）。치료조치료전 RDW 여 N 말단뇌납태전체（NT-proBNP）、초민 C-반응단백（hs-CRP）정정상관（r ＝0．783，P ＜0．01；r ＝0．870，P ＜0．01），여기항、혈홍단백정부상관（r ＝－0．338，P ＜0．01；r ＝－0．743，P ＜0．01）。치료조치료전후 RDW 차치여 NT-proBNP、hs-CRP 차치정정상관（r ＝0．783，P ＜0．01；r ＝0．680，P ＜0．01），여혈홍단백차치정부상관（r ＝－0．459，P ＜0．01），여기항、뇨산、LDL、담고순、감유삼지、LVEF 차치무명현상관성。결론촉홍세포생성소연합철제능유효개선만성심력쇠갈합병빈혈환자심공능，규정빈혈，강저 RDW 수평。RDW 수평여만성심력쇠갈합병빈혈환자병정적엄중정도정정상관，가작위만성심력쇠갈합병빈혈적환자병정평고급료효판단적관찰지표지일。
Objective To analyze the effect of erythropoietin therapy with oral iron supplementation on red blood cell distribution width (RDW)in chronic heart failure patients with anemia.Methods 148 patients of chronic heart failure with anemia from September 2014 to March 2015 in our hospital were included and randomly divided into two groups with the random number table,with 74 cases in each group.The control group were treated with convention-al anti heart failure therapy,the treatment group were treated with erythropoietin and oral iron supplementation on the basis of routine treatment for four weeks.RDW was tested by automatic five classification blood analyzer.The correla-tion between RDW and other detection indexes was analyzed.Results The levels of RDW in the treatment group were significantly lower than those of the control group[(13.08 ±0.792)vs (14.32 ±0.864),t =-8.974,P <0.01].Before treatment,bivariate analysis in the treatment group showed that RDW had positive correlation with NT-proBNP and high -sensitivity C -relative protein (hs -CRP)(r =0.783,P <0.01;r =0.870,P <0.01),but negative correlation with serum creatinine (Cr)and hemoglobin (r =-0.338,P <0.01;r =-0.743,P <0.01).Af-ter treatment,bivariate correlations analysis in the treatment group showed that the difference of RDW was positive correlation with the difference of NT -proBNP,high -sensitivity C -relative protein (hs -CRP)(r =0.783,P <0.01;r =0.680,P <0.01),but negative correlation with the difference of hemoglobin(r =-0.459,P <0.01),and no correlation with the others (Cr,UA,LDL,TC,TG and LVEF).Conclusion On the basis of conventional anti heart failure treatment,erythropoietin therapy with oral iron supplementation against anemia could improve heart func-tion of CHF and decrease the levels of RDW.RDW may be served as one of observing indexes of the worsening and effect judgment in chronic heart failure patients with anemia.