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目的观察促红细胞生成素治疗老年心力衰竭合并贫血的临床疗效及安全性。方法 73例老年心力衰竭合并贫血患者随机分为对照组36例与试验组37例。对照组接受常规抗心力衰竭治疗,试验组在对照组的基础上口服铁剂200 mg,同时皮下注射促红细胞生成素,每次3000 IU,1周2次,疗程为4个月。观察2组患者治疗前后的脑钠肽、血红蛋白、左心室射血分数、左心室舒张末期内径、6 min步行距离及心血管不良事件发生率。结果试验组患者治疗后脑钠肽水平显著小于治疗前及对照组治疗后(P<0.05)。试验组患者治疗后血红蛋白、左心室射血分数及6 min步行距离均显著大于治疗前及对照组治疗后(P<0.05)。对照组治疗前后上述指标差异均无统计学意义(P>0.05)。对照组治疗后心血管事件发生率为27.78%,显著高于试验组的13.51%(P<0.05)。结论促红细胞生成素辅助治疗老年心力衰竭合并贫血可显著提高临床疗效,降低主要心血管不良事件的发生率。
Objective To observe the clinical efficacy and safety of erythropoietin in the treatment of elderly patients with heart failure and anemia. Methods A total of 73 elderly patients with heart failure and anemia were randomly divided into control group (36 cases) and experimental group (37 cases). The control group received routine anti-heart failure treatment. The test group received oral iron 200 mg on the basis of the control group with subcutaneous injection of erythropoietin (3000 IU) twice a week for 4 months. The levels of brain natriuretic peptide, hemoglobin, left ventricular ejection fraction, end-diastolic diameter of left ventricle, walking distance of 6 min and the incidence of cardiovascular adverse events were observed before and after treatment. Results After treatment, the level of brain natriuretic peptide in the experimental group was significantly lower than that before treatment and in the control group after treatment (P <0.05). After treatment, hemoglobin, left ventricular ejection fraction and walking distance at 6 min in test group were significantly higher than those before treatment and control group after treatment (P <0.05). There was no significant difference between the control group before and after treatment (P> 0.05). The incidence of cardiovascular events in the control group after treatment was 27.78%, which was significantly higher than that in the experimental group (13.51%, P <0.05). Conclusion Erythropoietin adjuvant treatment of elderly patients with heart failure and anemia can significantly improve the clinical efficacy and reduce the incidence of major adverse cardiovascular events.