心脏骤停后相关性贫血的机制及治疗  

Mechanisms and treatment of anemia related to cardiac arrest

作　　者：彭祥 莫晓叶[1] 李湘民[1,2] PENG Xiang;MO Xiaoye;LI Xiangmin(Department of Emergency,Xiangya Hospital,Central South University,Changsha 410008;National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院急诊科,长沙410008 [2]国家老年疾病临床医学研究中心(湘雅医院),长沙410008

出　　处：《中南大学学报（医学版）》2024年第3期457-466,共10页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(82002010)。

摘　　要：心脏骤停是一种常见且致命的紧急情况。近来,越来越多的研究表明心脏骤停患者发生贫血与高病死率及神经功能预后差密切相关。在心脏骤停后综合征(post-cardiac arrest syndrome,PCAS)患者中普遍存在贫血,但具体发病机制不清。机制可能涉及多种因素,包括促红细胞生成素产生减少、氧化应激/炎症反应、胃肠道缺血性损伤、铁调素异常、医源性失血及营养不良等,可通过输血,给予促红细胞生成素,抗炎,抗氧自由基,补充造血原料,保护胃肠道黏膜,使用铁调素抗体及拮抗剂等措施来改善心脏骤停后相关性贫血。因此,探讨心脏骤停后相关性贫血的机制及治疗的最新研究进展,对于改善贫血导致的继发性脑损伤以及心脏骤停患者的预后具有重要的指导意义。Cardiac arrest is a common and fatal emergency situation.Recently,an increasing number of studies have shown that anemia in patients with cardiac arrest is closely related to high mortality rates and poor neurological outcomes.Anemia is prevalent among patients with post-cardiac arrest syndrome(PCAS),but its specific pathogenesis remains unclear.The mechanisms may involve various factors,including reduced production of erythropoietin,oxidative stress/inflammatory responses,gastrointestinal ischemic injury,hepcidin abnormalities,iatrogenic blood loss,and malnutrition.Measures to improve anemia related to cardiac arrest may include blood transfusions,administration of erythropoietin,antiinflammation and antioxidant therapies,supplementation of hematopoietic materials,protection of gastrointestinal mucosa,and use of hepcidin antibodies and antagonists.Therefore,exploring the latest research progress on the mechanisms and treatment of anemia related to cardiac arrest is of significant guiding importance for improving secondary brain injury caused by anemia and the prognosis of patients with cardiac arrest.

关 键 词：心脏骤停 贫血 氧化应激/炎症反应 铁调素 胃肠道缺血性损伤 

分 类 号：R73[医药卫生—肿瘤]