铁调素/铁蛋白比值在预测老年慢性心力衰竭患者铁缺乏中的应用价值  

Usefulness of the hepcidin-to-ferritin ratio in predicting iron deficiency in elderly patients with chronic heart failure

作　　者：李玉梅 郭丽丽 周冰洁 曹瑞娟 LI Yu-mei;GUO Li-li;ZHOU Bing-jie;CAO Rui-juan(Department of Internal Medicine,Yangchun People′s Hospital,Yangchun,Guangdong 529600,China)

机构地区：[1]阳春市人民医院内一科,广东阳春529600

出　　处：《岭南心血管病杂志》2020年第4期435-439,443,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的评价血清铁调素和铁蛋白作为老年慢性心力衰竭(chronic heart failure,CHF)患者生物标志物的潜在作用。方法本研究为前瞻性观察研究,对2015年4月至2017年11月阳春市人民医院61例CHF患者和30例无缺铁症、贫血和心功能不全的住院患者的血清铁调素、铁蛋白浓度进行测量。使用单变量和多因素Logistic回归分析来分析与老年CHF患者铁调素/铁蛋白比值改变相关的因素以及CHF的影响因素。结果在61例CHF患者中,36例(59%)诊断为缺铁症。缺铁症CHF患者在年龄、血红蛋白、铁浓度、铁蛋白、铁调素、铁调素/铁蛋白比值、转铁蛋白饱和度(transferrin,TSAT)、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、估算肾小球滤过率(eGFR)、高敏C反应蛋白(high sensitivity C-reactive protein,hsCRP)等指标与无缺铁症CHF患者和对照组比较,差异有统计学意义(P<0.05)。相关性分析结果显示,在老年CHF患者中,血清铁调素与铁蛋白呈正相关(r=0.67,P<0.01)。多因素Logistic回归模型中,铁调素/铁蛋白比值与女性、纽约心脏协会(NYHA)心功能分级、血清铁浓度降低、血浆NT-proBNP浓度升高和血清hs-CRP浓度升高独立相关(均P<0.05),并且铁调素/铁蛋白比值是CHF发展的独立危险因素。结论铁调素/铁蛋白比值可以作为老年CHF早期诊治的潜在生物标志物。Objective To investigate the potential role of serum hepcidin and ferritin as biomarkers in elderly patients with chronic heart failure(CHF).Methods In this prospective observational study,serum concentrations of hepcidin and ferritin in 61 elderly patients with CHF and 30 in hospital patients without iron deficiency,anemia and heart failure from April 2015 to November 2017 in Yangchun People’s Hospital were measured.Univariate and multivariate Logistic regression analysises were used to analyze the factors associated with ratio of hepcidin to ferritin and influence factors of CHF.Results Iron deficiency was diagnosed in 36 patients(59%)of 61 patients with CHF.The age,hemoglobin,iron concentration,ferritin,hepcidin,ratio of hepcidin to ferritin,transferrin(TSAT),N-terminal pro-brain natriuretic peptide(NT-proBNP),estimated glomerular filtration rate(eGFR),high sensitivity C-reactive protein(hs-CRP)and other indicators were significantly higher in CHF patients with iron deficiency compared with healthy controls and CHF patients without iron deficiency(P<0.05).Correlation analysis showed that there was a significant positive correlation between serum concentration of hepcidin and ferritin in elderly CHF patients(r=0.67,P<0.01).In the multivariate Logistic regression model,the ratio of hepcidin to ferritin independently associated with female,New York Heart Association(NYHA)heart function classification,serum concentration of iron,plasma concentration of NT-proBNP and serum concentration of hs-CRP(all P<0.05).The ratio of hepcidin to ferritin was an independent risk factor for the development of CHF.Conclusions The ratio of hepcidin to ferritin can be used as a potential biomarker for early diagnosis and treatment in elderly patients with CHF.

关 键 词：心力衰竭 缺铁症 铁蛋白 铁调素 老年 

分 类 号：R541.6[医药卫生—心血管疾病]