促红细胞生成素治疗老年慢性心力衰竭临床探究.docVIP

促红细胞生成素治疗老年慢性心力衰竭临床探究 　【摘要】 目的 本研究旨在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 2003年5月～2005年5月80例CHF患者随机分成治疗组(n=40)及对照组(n=40)。对照组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（βB)等药物。治疗组在对照组基础上皮下注射EPO 100IU/kg，每周1次，疗程6个月。结果 治疗组EPO治疗前后相比心功能测定LVEF、6min步行距离、心肌耗氧量峰值、血红蛋白均有显著改善(P＜0.05)，组间比较治疗组较对照组显著改善(P＜0.05)。结论 EPO能改善CHF患者的心功能状态及临床症状，提高运动耐量。　　【关键词】 促红细胞生成素；慢性心力衰竭；心功能分级 　　A clinic study of the therapuetic effects of the erythropoietin on the elder patients with chronic heart failure 　　【Abstract】 Objective To study the effect of erythopoietin (EPO) in the treatment of chronic heart failure (CHF) on the elder patients.Methods 80 cases of chronic heart failure were randomly divided into two groups. The patients in the control group (n=40) were individually given the routine treatment of CHF (diuretics, digoxin and ACEI). Beside the above routine， each patient in the study group (n=40) was given a dose of EPO, 100IU/kg hypodermic injection, once a week for six months. We measured the patients left ventricular ejection fraction (LVEF), hemoglobin(Hb) by the echocardiography and laboratory examination. We used the six-min-step walking examination and NYHA heart function classification to detect the patients heart function.Results It was obvious of the improvement in the LVEF, Hb of study group， as well as the improvement in the six-min-step walking distance and NYHA heart function classification after six months administration. The theraputic effect was significantly different between the two groups (Plt;0.05).Conclusion EPO treatment is a safe and effective method to treat CHF patients due to the much improvement of the heart function， exercise tolerance. 　　【Key words】 erythropoietin(EPO); chronic heart failure(CHF);heart function classification 　　促红细胞生成素(EPO)是由肾脏的皮-髓质交界处的球旁细胞合成的一种内分泌激素，随着人们对其作用的认识，其治疗领域已不限于终末期肾病及血透患者，其对心血管的作用已越来越引起人们的注意［1］ 。为探讨EPO对老年慢性心力衰竭(CHF)患者的治疗作用，笔者用 EPO 治疗 40 例 CHF 患者，现将结果报告如下。 　　1 资料与方法 　　1.1 一般资料 80例CHF患者均为我院2003年5月～2005