Efficacy of recombinant human erythropoietin on chronic heart failure with anemia
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摘要: 目的 观察重组人促红细胞生成素(EPO)联合常规抗心衰药物治疗慢性心力衰竭合并贫血的疗效以及对血清心肌酶相关指标、铁蛋白(SF)水平的影响。方法 抽取2018年7月至2019年12月收治的103例慢性心力衰竭合并贫血患者纳入研究对象, 按照随机数字表法分为对照组51例, 观察组52例, 对照组使用抗心衰常规治疗+铁剂治疗贫血, 观察组在对照组基础上增加使用重组人促红细胞生成素, 连续治疗8周后采用酶动力法检测2组患者治疗前后的血清心肌酶相关指标包括磷酸肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、磷酸肌酸激酶同工酶(CK-MB)及α-羟丁酸脱氢酶(α-HBDH)水平；采用酶联免疫吸附法检测患者治疗前、治疗4周、治疗8周后的SF水平；比较2组患者治疗前后的心功能及疗效。结果 观察组治疗有效率明显高于对照组(P< 0.05), 治疗后观察组患者的CK、LDH、AST、CK-MB与α-HBDH水平均明显低于对照组(P< 0.05), 2组患者血清SF水平、时间点及交互差异均有统计学意义(P< 0.05), 治疗后观察组左室射血分数明显高于对照组, 左室舒张末期内径明显小于对照组, 6 min步行距离明显大于对照组(P< 0.05)。结论 重组人促红细胞生成素用于慢性心力衰竭合并贫血可提高疗效, 降低血清心肌酶相关指标水平, 提高血清SF水平。
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关键词:
- 重组人促红细胞生成素 /
- 慢性心力衰竭 /
- 贫血 /
- 血清心肌酶 /
- 铁蛋白
Abstract: Objective To observe the efficacy of recombinant human erythropoietin(EPO) combined with conventional anti-heart failure drugs in the treatment of chronic heart failure with anemia and its influence on levels of serum myocardial enzyme-related indicators and serum ferritin(SF).Methods A total of 103 patients with chronic heart failure complicated with anemia admitted to the hospital were selected between July 2018 and December 2019 and included in the study. According to the random number table method, the patients were divided into 51 cases in control group and 52 cases in observation group. The control group was given conventional anti-heart failure treatment + iron preparation for anemia, and the observation group was additionally given recombinant human erythropoietin on the basis of the control group. After 8 weeks of continuous treatment, enzyme dynamic method was used to detect the levels of serum myocardial enzyme-related indicators before and after treatment in the two groups, including creatine kinase(CK), lactate dehydrogenase(LDH), aspartate aminotransferase(AST), creatine kinase isoenzymes(CK-MB) and α-hydroxybutyrate dehydrogenase(α-HBDH). Enzyme-linked immunosorbent assay was applied to detect the SF level of patients before treatment, after 4 weeks of treatment and after 8 weeks of treatment. The cardiac function and efficacy before and after treatment were compared between the two groups.Results The effective rate of treatment in observation group was higher than that in control group(P< 0.05). After treatment, the levels of CK, LDH, AST, CK-MB and α-HBDH were lower in observation group than those in control group(P< 0.05). There were statistically significant differences in between-group effect, time-point effect and interaction effect of serum SF level between the two groups(P< 0.05). After treatment, the left ventricular ejection fraction of observation group was higher than that of control group, and the left ventricular end diastolic diameter was shorter than that of control group, and the 6-min walking distance was longer than that of control group(P< 0.05).Conclusion Recombinant human erythropoietin can improve the efficacy, reduce the levels of serum myocardial enzyme-related indicators, and increase the level of serum SF in the treatment of chronic heart failure with anemia.-
Key words:
- recombinant human erythropoietin /
- chronic heart failure /
- anemia /
- serum myocardial enzymes /
- ferritin
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表 1 2组患者疗效比较
例 组别 例数 显效 有效 无效 有效率/例(%) 观察组 52 36 15 1 51(98.08) 对照组 51 29 16 6 45(88.24) χ2 3.937 P 0.047 
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表 2 2组患者治疗前后血清CK、LDH、AST、CK-MB与α-HBDH水平比较
X±S 组别 观察组(n=52) 对照组(n=51) 治疗前 治疗后 治疗前 治疗后 CK/(U·L-1) 267.85±54.63 172.82±30.151) 262.98±55.24 187.69±35.841) LDH/(U·L-1) 221.53±23.05 155.49±17.951) 224.97±25.51 172.64±18.891) AST/(U·L-1) 63.45±7.92 45.59±6.751) 64.53±8.08 49.16±7.211) CK-MB/% 37.89±6.85 30.67±5.231) 37.18±6.31 34.29±5.471) α-HBDH/(U·L-1) 245.48±69.87 124.18±38.251) 243.16±68.43 143.84±42.361) 与治疗前比较，1)P < 0.05。
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表 3 治疗前与治疗后不同时间血清SF水平变化比较
ng/mL，X±S 组别 例数 治疗前 治疗4周 治疗8周 观察组 52 175.33±53.28 196.32±58.591) 224.85±60.221) 对照组 51 174.81±54.02 182.47±59.141) 198.78±61.371) 与治疗前比较，1)P < 0.05。
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表 4 2组患者治疗前后心功能比较
X±S 组别 例数 LVEF/% LVEDD/mm 6 min步行距离/m 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 52 23.86±1.07 53.13±3.161) 56.39±6.79 38.97±4.511) 366.45±74.52 436.05±68.541) 对照组 51 24.11±1.03 49.68±3.32 57.14±6.95 42.73±4.23 368.17±73.88 402.43±71.29 与对照组比较，1)P < 0.05。
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