铁缺乏及其与慢性心力衰竭的关系--综述。

Arshdeep Kaur, Ranjeet Kumar
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引用次数: 0

摘要

缺铁(ID)在心血管疾病患者中很常见。超过 6400 万患者患有慢性心力衰竭。目的:这篇综述文章讨论了慢性心力衰竭(CHF)的多因素病理生理学、临床特征、功能性和绝对性缺铁之间的关系以及药物干预的优势。文章还论述了铁缺乏对身体其他部位的影响:方法:选取了最近发表的、包含大量科学数据的、关于慢性心力衰竭与ID(伴有或不伴有贫血)之间关系的文章:讨论:在这些患者中发现了复杂的生理病理相互作用,包括较高的血红素水平、全身炎症和肾素-血管紧张素-醛固酮系统的激活。这些机制加剧了贫血、慢性心力衰竭(CHF)和慢性肾病(CKD)的严重程度,从而加重了患者的病情。该领域的研究一直很有限,研究结果也不一致。尽管如此,该研究也对循证治疗方法和诊断指南进行了审查,尤其是与铁补充剂和促红细胞生成素药物有关的方面:贫血是慢性心力衰竭的常见后果,也是预后不良的因素之一。我们仍不完全了解贫血的许多复杂原因。我们强烈建议对心脏病患者进行缺铁筛查,因为这对他们的预后非常重要。由于证明其有效性的研究较少,胃肠道副作用的发生率较高,以及提高血红蛋白水平所需的治疗时间较长,因此不建议慢性心力衰竭患者口服铁质补充剂。铁元素不足不仅会影响心脏,还会影响身体的其他组成部分。
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Iron Deficiency and its Relationship with Chronic Heart Failure- A Review.

Iron Deficiency (ID) is common in patients with cardiovascular disease. More than 64 million patients are suffering from chronic heart failure. The prevalence of iron deficiency increases with the severity of cardiac and renal dysfunction and is probably more common amongst women.

Aim: This review article discusses multifactorial pathophysiology, the relationship between clinical characteristics, functional and absolute ID, and the advantages of medicinal intervention in chronic heart failure (CHF). It also covers how iron shortage affects other body parts.

Approach: The most recent publications that included substantial scientific data on the connection between CHF and ID, with or without anaemia, were selected.

Discussion: Complex physiopathological interactions, including higher hepcidin levels, systemic inflammation, and activation of the renin-angiotensin-aldosterone system, have been identified in these patients. These mechanisms exacerbate the outcomes for patients by amplifying the severity of anemia, chronic heart failure (CHF), and Chronic kidney disease (CKD). Research in this area has been limited and has shown inconsistent findings. Still, it has also examined evidence-based treatment approaches and diagnostic guidelines, especially in relation to iron supplements and erythropoietin-stimulating medications.

Conclusion: Anemia is a frequent chronic heart failure consequence and a poor prognostic factor. We still don't completely understand the many complex causes of anemia. Iron deficiency screening is highly recommended for people with cardiac ailments because of its significance for their prognoses. Due to the paucity of research proving its effectiveness, the high incidence of unfavourable gastrointestinal side effects, and the prolonged length of time required for treatment to boost haemoglobin levels, an oral iron supplement is not advised for people with chronic heart failure. An insufficient amount of iron not only impacts the heart but also various other body components.

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