慢性心力衰竭贫血病理纠正的新可能性

A. A. Gurkina, N. I. Stuklov, N. D. Kislyj, R. R. Gimadiev, A. A. Strel’nikov
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摘要

如果慢性心力衰竭(CHF)伴有贫血综合征,并且对治疗产生了铁缺乏症(ID)耐受性,那么作为治疗CHF基础的药物的有效性就会降低,预后也会恶化。的目标。根据CHF合并贫血患者的铁代谢、红细胞生成和炎症水平的特点,评估使用具有hepcidin非依赖性吸收机制的铁制剂的可能性。材料和方法。该研究纳入68例诊断为CHF的患者,以描述贫血的特征(普通组)。此外,56名签署同意研究的患者被分为两组:30名患者(治疗组)接受标准CHF治疗和铁制剂,26名患者(对照组)仅接受标准CHF治疗。上体铁(SI)每天口服60毫克,持续3个月。结果。CHF贫血的变体:绝对ID (AID) - 43%,功能性ID (FID) - 19%,无ID贫血- 38%。治疗组血红蛋白(Hb, p <0.002),红细胞压积(Ht, p <0.001),平均红细胞体积(MCV, p <0.002)和血清铁蛋白(SF, p <0.05), Сomparison组只有Ht, p <0.01, SF <患者Hb升高幅度最大;30 μmol/l (p <0.002)。结论。CHF的贫血对应于慢性疾病贫血(ACD)伴J的体征,而在62%的患者中检测到J。使用SI可显著增加红细胞计数和SF/
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New possibilities of pathogenetic correction of anemia in chronic heart failure
If chronic heart failure (CHF) is accompanied by anemic syndrome and iron defi ciency (ID) tolerance to treatment develops, the eff ectiveness of drugs that form the basis of CHF treatment decreases, and the prognosis worsens. Aim . To evaluate the possibilities of using iron preparations with hepcidin-independent absorption mechanism depending on the characteristics of iron metabolism, erythropoiesis and the level of infl ammation in patients with CHF and anemia. Material and methods. The study included 68 patients diagnosed with CHF to describe the characteristics of anemia (General group). Further, 56 patients who signed consent to the study were divided into two groups: 30 patients (Treatment Group) with standard CHF therapy and iron preparations, and 26 (Comparison Group) with standard CHF therapy only. Sucrosomial iron (SI) was used 60 mg per day orally for three months. Results . Variants of anemia in CHF: absolute ID (AID) — 43%, functional ID (FID) — 19%, anemia without ID — 38%. In the treatment group, an increase in hemoglobin (Hb, p < 0.002), hematocrit (Ht, p < 0.001), mean corpuscular volume (MCV, p < 0.002) and serum ferritin (SF, p < 0.05), in the Сomparison group only Ht, p < 0.01, and the greatest increase in Hb was detected in patients with SF < 30 μmol/l (p < 0.002). Conclusion . Anemia in CHF corresponds to the signs of anemia of chronic disease (ACD) with J, while J was detected in 62% of patients. The use of SI signifi cantly increases erythrocyte counts and SF/
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