Cardiology Section, Department of Internal Medicine and Metabolic Diseases, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy.
Clin Exp Med. 2011 Mar;11(1):43-8. doi: 10.1007/s10238-010-0100-y. Epub 2010 May 29.
Little is known about the effect of anemia correction with erythropoietin (EPO) on B-type natriuretic peptide (BNP) levels, NYHA class, and hospitalization rate. The aim of the study was to investigate, in patients with cardio-renal anemia syndrome, the effects of EPO on hemochrome and renal function parameters and BNP levels. We also analyzed the effect of EPO therapy on hospitalization rate and NYHA class after 12 months in comparison with a population undergoing to standard therapy. We performed a randomized double-blind controlled study of correction of the anemia with subcutaneous α (group A n = 13) or β (group B n = 14) EPO for 12 months in addition to standard therapy with oral iron in 27 subjects. Control group (n = 25 patients) received only oral iron. Significant increase in hemoglobin (Hb), hematocrit (Hct), and red blood cells (RBC) were revealed in EPO groups at 12 months; Hb, group A 12.3 ± 0.6; group B 11.7 ± 0.8; control group 10.6 ± 0.5 g/dl P < 0.0001; Hct group A 34.2 ± 2.3, group B 34 ± 2, control group 32.3 ± 1.8% P < 0.01; RBC, group A 3.9 ± 0.2, group B 3.8 ± 0.2, control group 3.3 ± 0.2, (P < 0.0001). Plasma BNP levels in EPO groups were significantly reduced after 12 months (group A: 335 ± 138 vs. group B: 449 ± 274 pg/ml control group 582 ± 209 pg/ml (P < 0.01). After 12 months of treatment, hospitalization rate and NYHA class were reduced in EPO groups with respect to control group (P < 0.05). Finally, an inverse correlation was observed between BNP and Hb levels in EPO Groups (r = -0.70 P < 0.001). EPO treatment reduces BNP levels and hospitalization rate in patients with cardio-renal anemia syndrome. The correction of anemia by EPO treatment appears able to improve clinical outcome in this subset of patients with heart failure.
关于促红细胞生成素（EPO）纠正贫血对 B 型利钠肽（BNP）水平、NYHA 分级和住院率的影响知之甚少。本研究旨在探讨在伴有心肾贫血综合征的患者中，EPO 对血色素和肾功能参数及 BNP 水平的影响。我们还分析了与接受标准治疗的人群相比，12 个月时 EPO 治疗对住院率和 NYHA 分级的影响。我们对 27 例患者进行了一项随机、双盲、对照研究，在标准治疗（口服铁剂）的基础上，皮下给予 α（A 组，n = 13）或 β（B 组，n = 14）EPO 纠正贫血，持续 12 个月。对照组（n = 25 例患者）仅接受口服铁剂。12 个月时，EPO 组的血红蛋白（Hb）、血细胞比容（Hct）和红细胞（RBC）显著增加；A 组 Hb 为 12.3 ± 0.6g/dl，B 组为 11.7 ± 0.8g/dl，对照组为 10.6 ± 0.5g/dl（P < 0.0001）；A 组 Hct 为 34.2 ± 2.3%，B 组为 34 ± 2%，对照组为 32.3 ± 1.8%（P < 0.01）；A 组 RBC 为 3.9 ± 0.2，B 组为 3.8 ± 0.2，对照组为 3.3 ± 0.2（P < 0.0001）。EPO 组治疗 12 个月后 BNP 水平显著降低（A 组：335 ± 138 vs. B 组：449 ± 274 pg/ml，对照组：582 ± 209 pg/ml，P < 0.01）。与对照组相比，EPO 组治疗 12 个月后住院率和 NYHA 分级降低（P < 0.05）。最后，EPO 组 BNP 与 Hb 水平呈负相关（r = -0.70，P < 0.001）。EPO 治疗可降低心肾贫血综合征患者的 BNP 水平和住院率。EPO 纠正贫血似乎能够改善心力衰竭患者的临床预后。
