Cardiovasc Ther:缺铁心衰患者IV铁治疗有何获益?

2017-12-05 吴星 环球医学

2017年12月,英国科学家在《Cardiovasc Ther》发文,考察了铁缺乏的心衰患者中,静脉注射铁治疗的疗效和安全性。

2017年12月,英国科学家在《Cardiovasc Ther》发文,考察了铁缺乏的心衰患者中,静脉注射铁治疗的疗效和安全性。

目的:讨论慢性心衰(CHF)中铁代谢的病理生理学和目前对CHF患者静脉(IV)铁治疗的疗效的认识,并确定争议点以及未来研究的强化领域。

讨论:铁缺乏是许多慢性疾病公认的并发症。很多研究已经报告,CHF患者缺铁非常普遍,且缺铁与运动不耐受、生活质量降低和住院及死亡风险增加相关。一些小型研究已经表明,IV铁与缺铁的CHF患者的症状、运动能力、生活质量、肾功能、纽约心脏协会(NYHA)功能分级、左心室射血分数(LVEF)改善,以及N末端脑钠肽前体(NT-proBNP)降低相关。两项证实这些结果的大规模试验(FAIR-HF和CONFIRM-HF)已产生指南推荐:射血分数降低且缺铁的CHF患者(血清铁蛋白<100 μg/L,或在100至299 μg/L之间且运铁蛋白饱和度<20%)应考虑IV铁治疗,以提供症状缓解并改善运动能力和生活质量。

结果:静脉注射铁治疗至少在短期至中期内改善症状、运动能力和生活质量。然而,当前仍没有可用于定义铁缺乏的标准,而且CHF患者中缺铁的根本机制仍未完全理解。需要进一步工作,以改善定义CHF患者缺铁的能力,并评价铁饱和对包括住院和死亡在内的硬终点的影响。

原始出处

Kang CK, Pope M, Lang CC, et al. Iron deficiency in heart failure: Efficacy and safety of intravenous iron therapy. Cardiovasc Ther. 2017 Dec;35(6). doi: 10.1111/1755-5922.12301. Epub 2017 Sep 25.

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    2018-09-01 quxin068
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    2017-12-05 changjiu

    学习一下谢谢

    0

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    2017-12-05 Jackie Li

    学习

    0

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