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目的:探讨促红细胞生成素(EPO)对慢性充血性心力衰竭(CHF)患者心功能及心肌细胞凋亡的影响。方法:选择CHF患者62例,随机分为EPO治疗组与对照组各31例,两组患者均接受规范的CHF药物治疗,EPO治疗组在此基础上再接受每周2次重组人EPO 2 000 U皮下注射,疗程3个月。比较研究初始及结束时两组患者的血常规、脑钠肽、可溶性凋亡相关因子(sFas)、可溶性凋亡相关因子配体(sFasL)及心脏彩声多普勒超声结果;观察两组患者心血管事件发生率。结果:研究结束时,EPO治疗组患者血浆脑钠肽、sFas、sFasL水平及因心力衰竭再次住院率均明显低于对照组(P均﹤0.05);对照组患者血红蛋白水平较EPO治疗组略有降低,但两组比较差异无统计学意义;两组间LVEF比较差异无统计学意义(P>0.05)。两组治疗过程中均无出现明显不良反应。结论:在规范的CHF治疗基础上,对CHF患者加用小剂量EPO,可减少患者的贫血及心肌细胞凋亡发生率,改善心功能,并可减少再次因心力衰竭住院率,安全性高。
Objective: To investigate the effects of erythropoietin (EPO) on cardiac function and cardiomyocyte apoptosis in patients with chronic congestive heart failure (CHF). Methods: Sixty-two CHF patients were randomly divided into EPO treatment group and control group, 31 cases in each group. Both groups received standard CHF drug treatment. On the basis of this, EPO treatment group received twice weekly recombinant human EPO 2 000 U subcutaneous injection, treatment for 3 months. The blood routine, brain natriuretic peptide, sFas, soluble Fas ligand (sFasL) and color Doppler echocardiography were compared between the two groups at the beginning and the end of the study. The incidence of cardiovascular events. Results: At the end of the study, plasma BNP, sFas, sFasL levels and re-hospitalization rates due to HF were significantly lower in EPO-treated patients (all P <0.05); hemoglobin levels were slightly higher in EPO-treated patients than in EPO-treated patients But there was no significant difference between the two groups. There was no significant difference in LVEF between the two groups (P> 0.05). No significant adverse reactions occurred in the two groups during the treatment. Conclusion: Based on the standard CHF treatment, the addition of low-dose EPO to CHF patients can reduce the incidence of anemia and cardiomyocyte apoptosis, improve cardiac function, and reduce the incidence of hospitalization for heart failure again, with high safety.