铁代谢指标和血红蛋白在慢性心力衰竭患者中的意义研究  

Significance of iron metabolism indexes and hemoglobin in patients with chronic heart failure

作　　者：赵瑞芳 高淑彦 王品 沈青青 ZHAO Rui-fang;GAO Shu-yan;WANG Pin(Department of Cardiology,Xingtai Central Hospital,Xingtai Hebei 054000,China)

机构地区：[1]邢台市中心医院心内科,河北邢台054000 [2]邢台市中心医院心脏康复科,河北邢台054000

出　　处：《临床和实验医学杂志》2025年第2期125-128,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题(编号:20191676)。

摘　　要：目的探讨铁代谢指标和血红蛋白在慢性心力衰竭(CHF)患者中的临床意义。方法采用前瞻性研究,共纳入2020年1月至2022年1月于邢台市中心医院心内科病房住院的CHF患者100例作为CHF组,并根据美国纽约心脏病学会(NYHA)分级分为NYHAⅡ级17例,NYHAⅢ级44例,NYHAⅣ级39例。收集同时期于我院体检的健康人员100名作为对照组。检测所有研究对象空腹时的铁代谢指标[血清铁、血清铁蛋白(SF)、总铁结合力(TIBC)、转铁蛋白饱和度(TSAT)]和血红蛋白水平,并比较上述指标在不同组间的差异,采用二元Logistic回归分析评估与CHF相关的危险因素。采用受试者操作特征(ROC)曲线评估预测CHF发生的价值。结果CHF组的血清铁、SF、TSAT、血红蛋白水平分别为(10.17±4.96)μmol/L、(176.48±89.53)ng/mL、(16.29±4.85)%、(112.14±21.35)g/L,均明显低于对照组[(19.24±5.18)μmol/L、(239.56±87.28)ng/mL、(24.57±5.19)%、(143.92±22.45)g/L],铁缺乏及贫血的发生率分别为71.0%、53.0%,均明显高于对照组(15.0%、2.0%),差异均有统计学意义(P<0.05);两组TIBC水平比较,差异无统计学意义(P>0.05)。与对照组比较,血清铁、SF、TSAT、血红蛋白水平、铁缺乏发生率、贫血发生率在NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组之间差异均有统计学意义(P<0.05),且随着心功能的下降呈降低趋势,铁缺乏发生率、贫血发生率呈升高趋势。二元Logistics回归分析显示血红蛋白是CHF发生的独立危险因素(OR=1.065,95%CI:1.037~1.149,P=0.037)。血红蛋白对CHF的进展具有一定的预测价值,血红蛋白预测CHF发生的曲线下面积为0.793(95%CI:0.784~0.856,P<0.001),敏感度为85.7%,特异度为82.3%。结论CHF患者血清铁、SF、TSAT、血红蛋白水平均明显降低,且随着心功能的下降血清铁、SF、TSAT、血红蛋白水平也逐渐下降,铁缺乏发生率、贫血发生率随着心功能的下降而升高。血红蛋白是CHF进展的独立危险因素,�Objective To explore the clinical significance of iron metabolism indexes and hemoglobin in patients with chronic heart failure(CHF).Methods This study was a prospective study.One hundred patients with chronic heart failure who were hospitalized in the cardiology ward of Xingtai Central Hospital from January 2020 to January 2022 were included as CHF group,according to the New York Heart Association(NYHA)grade,there were 17 cases of NYHA gradeⅡgroup,44 cases of NYHA gradeⅢgroup,and 39 cases of NYHA gradeⅣgroup.A total of 100 healthy people who underwent physical examination in our hospital during the same period were collected as the control group.The iron metabolic indicators[serum iron,including serum ferritin(SF),total iron-binding capacity(TIBC),transferrin saturation(TSAT)]and hemoglobin of all subjects were measured on an empty stomach,and the differences of above indicators among different groups were compared.The risk factors associated with CHF were evaluated by binary Logistic regression analysis.The predictive value of predicting the occurrence of CHF was evaluated by receiver operating characteristic(ROC)curve.Results The levels of serum iron,SF,TSAT and hemoglobin in CHF group were(10.17±4.96)μmol/L,(176.48±89.53)ng/mL,(16.29±4.85)%and(112.14±21.35)g/L,respectively,which were significantly lower than those in control group[(19.24±5.18)μmol/L,(239.56±87.28)ng/mL,(24.57±5.19)%,(143.92±22.45)g/L],the incidence of iron deficiency and anemia were 71.0%and 53.0%,respectively,which were significantly higher than those in the control group(15.0%,2.0%),and the differences were statistically significant(P<0.05).There was no statistically significant difference in TIBC level between the two groups(P>0.05).Compared with the control group,the levels of serum iron,SF,TSAT,hemoglobin,the incidence of iron deficiency and anemia were significantly different among NYHAⅡgroup,NYHAⅢgroup and NYHAⅣgroup(P<0.05).With the decrease of cardiac function,the levels of serum iron,SF,TSAT and hemoglobin decr

关 键 词：心力衰竭 血红蛋白类 铁代谢 心功能 

分 类 号：R54[医药卫生—心血管疾病]