不同补铁途径对合并缺铁性贫血的心力衰竭患者血清铁指标和Hcy及NT-proBNP水平的影响  

Effects of Different Iron Supplementation Ways on Serum Iron Indexes,Hcy and NT-proBNP Levels in Patients with Heart Failure Combined with Iron Deficient Anemia

作　　者：屈伶玉 孙小燕 杨雷 吴泽阳 王蕾 QU Lingyu;SUN Xiaoyan;YANG Lei;WU Zeyang;WANG Lei(Department of Rehabilitation,Zhangjiakou First Hospital,Zhangjiakou 075000,China;Department Three of Cardiology,Zhangjiakou First Hospital,Zhangjiakou 075000,China;Department of Hematology,Zhangjiakou First Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院康复科,河北张家口075000 [2]张家口市第一医院心内三科,河北张家口075000 [3]张家口市第一医院血液科,河北张家口075000

出　　处：《医学综述》2023年第10期2070-2075,共6页Medical Recapitulate

基　　金：张家口市重点研发计划项目(2121151D)。

摘　　要：目的分析不同补铁途径对合并缺铁性贫血的心力衰竭患者血清铁指标和同型半胱氨酸(Hcy)及N端脑钠肽前体(NT-proBNP)水平的影响。方法选取2020年8月至2021年8月张家口市第一医院收治的95例合并缺铁性贫血的心力衰竭患者为研究对象,均给予常规抗心力衰竭治疗,并根据补铁途径的不同分为静脉组(50例,采用静脉滴注蔗糖铁补铁)和口服组(45例,给予多糖铁复合物胶囊补铁)。比较两组血清铁指标[铁蛋白、血红蛋白(Hb)、血清铁、转铁蛋白饱和度、总铁结合力]、左心室射血分数(LVEF)、6 min步行距离、纽约心脏病协会(NYHA)心功能分级、Hcy及NT-proBNP水平变化,及不良反应发生情况。结果血清铁蛋白、Hb、血清铁、转铁蛋白饱和度水平时点间的主效应差异有统计学意义(P<0.01),总铁结合力水平时点间的主效应差异无统计学意义(P>0.05);血清铁蛋白、转铁蛋白饱和度和总铁结合力水平组间的主效应差异无统计学意义(P>0.05),Hb、血清铁水平组间的主效应差异有统计学意义(P<0.01);血清铁蛋白、转铁蛋白饱和度和总铁结合力水平的组间与时点间不存在交互作用(P>0.05),Hb、血清铁水平的组间与时点间存在交互作用(P<0.01)。与治疗前相比,治疗后两组血清铁蛋白、Hb、血清铁、转铁蛋白饱和度水平均升高(P<0.05),且静脉组的Hb、血清铁水平高于口服组(P<0.05)。LVEF、6 min步行距离时点间的主效应差异有统计学意义(P<0.01),组间的主效应差异无统计学意义(P>0.05),组间与时点间不存在交互作用(P>0.05);与治疗前相比,治疗后两组LVEF升高、6 min步行距离延长(P<0.05)。治疗后,口服组、静脉组NYHA心功能分级均优于治疗前(均P<0.01),但静脉组与口服组的NYHA心功能分级比较差异无统计学意义(P>0.05)。Hcy、NT-proBNP水平时点间的主效应差异有统计学意义(P<0.01),组间的主效应差异无统计学意义(P>0.05),组间�Objective To analyze the effects of different ways of iron supplementation on serum iron index,homocysteine(Hcy)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in patients with heart failure complicated with iron deficient anemia.Methods A total of 95 patients with heart failure complicated with iron deficiency anemia admitted to Zhangjiakou First Hospital from Aug.2020 to Aug.2021 were included.They were all given routine anti-heart failure treatment,and were divided into an intravenous group(50 cases,using intravenous infusion of sucrose iron to supplement iron)and an oral group(45 cases,using polysaccharide iron complex capsule to supplement iron)according to different ways of iron supplementation.The changes of serum iron index[ferritin,hemoglobin(Hb),serum iron,transferrin saturation,total iron binding capacity],left ventricular ejection fraction(LVEF),6-min walking distance,New York Heart Association(NYHA)cardiac function classification,Hcy and NT-proBNP levels,and adverse reactions were compared between the two groups.Results There were significant differences in the main effects of serum ferritin,Hb,serum iron and transferrin saturation between time points(P<0.01),but there was no significant difference in the main effect of total iron binding capacity between time points(P>0.05).There were no significant differences in the main effects of serum ferritin,transferrin saturation and total iron binding capacity between groups(P>0.05),but there were significant differences in the main effects of Hb and serum iron levels between groups(P<0.01).Serum ferritin,transferrin saturation and total iron binding capacity had no interactions between groups and time points(P>0.05),but Hb and serum iron levels had interactions between groups and time points(P<0.01).Compared with before treatment,the levels of serum ferritin,Hb,serum iron and transferrin saturation in the two groups were increased after treatment(P<0.05),and the levels of Hb and serum iron in the intravenous group were higher than those in th

关 键 词：心力衰竭 缺铁性贫血 补铁途径 同型半胱氨酸 N端脑钠肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]