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目的在心衰合并贫血患者中,观察纠正贫血是否可使不同心衰分级患者均可获益。方法在心衰合并贫血患者中,根据纽约心功能分级将患者依次分为NYHAⅡ～IV级组,在各级分组中再分为铁剂组及对照组。随访观察半年,比较观察两组患者血红蛋白(Hb)、C反应蛋白(CRP)、丙二醛(MDA)和超氧化物歧化酶(SOD)、左室射血分数(EF)的变化,以及比较6分钟步行试验(6mWT)和两组患者因心衰恶化而再住院次数。结果经过铁剂予以纠正贫血,NYHAⅡ级患者,铁剂组Hb较对照组显著升高,MDA、SOD、CRP、EF值、6mWT等差异无统计学意义(P>0.05),再住院次数两组无差异,而在NYHAⅢ、IV级患者中,与对照组比较,EF值差异无统计学意义(P>0.05),而其余指标均比较差异有统计学意义(P<0.05)。结论在心衰合并贫血患者中,通过铁剂纠正贫血,主要使NYHAⅢ、IV级心衰患者临床获益。
Objective To observe whether correcting anemia can benefit patients with different heart failure in patients with heart failure and anemia. Methods In patients with heart failure and anemia, NYHA class Ⅱ ~ IV patients were divided into NYHA class according to New York Heart Association grading and subdivided into iron group and control group. The changes of hemoglobin (Hb), C reactive protein (CRP), malondialdehyde (MDA), superoxide dismutase (SOD) and left ventricular ejection fraction (EF) were compared between the two groups. 6-minute walk test (6mWT) and rehospitalization in both groups due to worsening heart failure. Results After treatment with iron, the level of Hb in NYHA class Ⅱ patients and iron group were significantly higher than those in control group (P 0.05). There was no significant difference in MDA, SOD, CRP, EF, 6mWT between the two groups There was no difference in NYHA class Ⅲ and Ⅳ patients between the two groups. There was no significant difference in EF between the two groups (P> 0.05), while the other indexes were significantly different (P <0.05). Conclusions In patients with heart failure complicated with anemia, iron supplementation is the most effective method to correct NYHA class Ⅲ and IV heart failure patients.