文章摘要
黎雪娇,李强翔,李文静,等.铁调素对老年慢性心力衰竭并铁缺乏患者的影响[J].中国临床保健杂志,2024,27(2):232-236.
铁调素对老年慢性心力衰竭并铁缺乏患者的影响
Effects of hepcidin in elderly patients with chronic heart failure and iron deficiency
投稿时间：2023-08-20  
DOI：10.3969/J.issn.1672-6790.2024.02.019
中文关键词: 心力衰竭  铁缺乏症  铁右旋糖酐复合物  投药途径  老年人
英文关键词: Heart failure  Iron deficiencies  Iron-dextran complex  Drug administration routes  Aged 〖FL
基金项目:湖南省卫生健康委科研计划项目(20200102)；湖南省教育厅科学研究项目(21A0044)；湖南老年重大慢性病临床医学研究中心项目(2023SK4054)
作者单位E-mail
黎雪娇 湖南师范大学附属第一医院湖南省人民医院,老年医学科,长沙 410002 friendpeng123@163.com 
李强翔 湖南师范大学附属第一医院湖南省人民医院,老年医学科,长沙 410002
湖南省老年医学研究所 		friendpeng123@163.com 
李文静 湖南师范大学附属第一医院湖南省人民医院,老年医学科,长沙 410002 friendpeng123@163.com 
曾巍 湖南师范大学附属第一医院湖南省人民医院,老年医学科,长沙 410002 friendpeng123@163.com 
漆雨晨 湖南师范大学附属第一医院湖南省人民医院心内科,长沙 410002 friendpeng123@163.com 
彭友 湖南师范大学附属第一医院湖南省人民医院,老年医学科,长沙 410002 friendpeng123@163.com 
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中文摘要:
      目的 探讨铁调素在老年慢性心力衰竭(CHF)并铁缺乏患者中的表达及与心功能相关性,不同途径补铁治疗对患者铁代谢、心功能及心肌重构的影响,并探讨其临床意义。方法 选取2021年3月至2022年12月在湖南师范大学附属第一医院(湖南省人民医院)收治的90例老年CHF伴缺铁患者,分为常规治疗组、常规+口服补铁治疗组与常规+静脉补铁治疗组,每组30例。常规治疗组予常规抗心力衰竭药物治疗,常规+口服补铁治疗组予常规+口服多糖铁复合物胶囊治疗,常规+静脉补铁治疗组予常规+静脉注射右旋糖酐铁治疗。治疗前及治疗8周后随访检测B型脑利钠肽前体(NT-proBNP)、6 min步行实验(6MWT)、美国纽约心脏病学会(NYHA)分级、舒张末期左心室内径(LVEDD)、左心室射血分数(LVEF)、左心房内径(LA)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、铁调素水平(Hep)、血红蛋白(Hb)、血清铁蛋白(SF)、转铁蛋白饱和度(TS)以观察机体心功能、心肌重构情况及铁状态。结果 3组患者治疗前后心功能相关指标(NT-proBNP、6MWT、LVEF、NYHA分级)、心肌重构相关指标(LA)、铁代谢相关指标(Hep、Hb、SF、TS)比较,差异均有统计学意义(P＜0.05);3组治疗前后LVEDD、IVST、LVPWT差异无统计学意义(P＞0.05)。血清铁调素与NT-proBNP及NYHA分级水平呈正相关性(P＜0.05),与6MWT、LVEF、Hb、TS、SF呈负相关性(P＜0.05)。结论 对于老年CHF并缺铁患者,补充铁剂可显著改善铁缺乏、心功能及心房重构,静脉补充比口服补充获益更大；铁调素的水平与心功能呈负相关。
英文摘要:
      Objective To explore the relationship between hepcidin expression and cardiac function in elderly CHF patients with iron deficiency,and the effects of different ways of iron supplementation on iron metabolism,cardiac function and myocardial remodeling,and explore its clinical significance.Methods Ninety elderly CHF patients with iron deficiency treated at the First Affiliated Hospital of Hunan Normal University (Hunan Provincial People′s Hospital) from March 2021 to December 2022 were selected.They were divided into routine treatment group,routine combind with oral iron supplementation treatment group and routine combind with intravenous iron supplementation treatment group,30 cases each group was given conventional anti-heart failure drugs,routine combind with oral iron supplementation treatment group was given routine combind with oral polysaccharide iron complex capsule treatment,and routine combind with intravenous iron supplementation treatment group and intravenous injection of dextran iron treatment group.Before treatment and after 8 weeks of treatment,the serum precursor B-type brain natriuretic peptide (NT-proBNP),6-minute walk test (6MWT),NYHA grade,left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),left atrial diameter (LA),interventricular septum thickness (IVST),left ventricular posterior wall thickness (LVPWT),serum hepcidin(Hep),hemoglobin (Hb),serum ferritin (SF),transferrin saturation (TS) were measured.Results Before and after treatment,the patients in the conventional treatment group,the conventional +oral iron supplementation treatment group,and the conventional +intravenous iron supplementation treatment group had NT-proBNP,6MWT,LVEF,and NYHA grades related to cardiac function;Myocardial remodeling related indicators LA;There was a statistically significant difference in iron metabolism related indicators Hep,Hb,SF,TS (P<0.05),while there was no statistically significant difference in LVEDD,IVST,and LVPWT among the three groups before and after treatment (P>0.05).There was a positive correlation (P<0.05) between serum ferritin and the levels of NT-proBNP and NYHA grading before treatment;Negative correlation with 6MWT,LVEF,Hb,TS,SF (P<0.05).Conclusions For elderly CHF patients with iron deficiency,iron supplementation can significantly improve iron deficiency,heart function and atrial remodeling,and intravenous supplementation is more beneficial than oral supplementation.The level of serum hepcidin is negatively correlated with cardiac function.
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