血清铁缺乏与慢性心力衰竭患者临床预后的关系研究

Correlation between iron deficiency and prognosis in patients with chronic heart failure

目的:探讨慢性心力衰竭(CHF)患者血清铁水平与心脏功能及预后的关系。方法:选取住院治疗的CHF患者178例,根据入院时的血清铁水平将患者分为正常组与铁缺乏组,采用心脏超声检测计算左室射血分数(LVEF),应用6min步行试验评估运动耐力。随访6个月,统计心脏不良事件(死亡、心力衰竭、再次入院、脑卒中或急性冠脉综合征)发生率。结果:铁缺乏组心力衰竭症状显著加重,N末端脑钠肽前体(NT-proBNP)水平增加,而LVEF值及6min步行距离低于正常组。相关性分析发现,铁缺乏组血清铁、血清铁蛋白水平均与NTproBNP和心功能分级呈负相关,与6min步行距离和LVEF呈正相关。6个月随访发现:铁缺乏组心力衰竭发生率及再入院率显著增高,但病死率、脑卒中及急性冠脉综合征发生率无统计学差异。结论:血清铁缺乏对心力衰竭程度及临床预后判断具有重要意义。

Objective：To investigate the relationship between iron deficiency（ID）and clinical prognosis in patients with chronic heart failure（CHF）.Method：A total of 178 patients with CHF were divided into normal group and ID group.Echocardiography assay was performed to evaluate the left ventricular ejection fraction（LVEF）.Meanwhile,6-minute walk distances（6MWD）were assessed.The major adverse cardiovascular events（MACE）during the 6months were observed and compared.Result：In the ID group,the symptoms of heart failure were significantly increased,and the NT-proBNP level increased,while the LVEF and 6MWD were lower than those in the normal group.The correlation analysis showed that the serum iron,serum ferritin levels were negatively correlated with NT-proBNP and cardiac function classification,and positively correlated with 6MWD and LVEF.Six months follow-up showed that the incidence of heart failure in the ID group was significantly higher,but there was no significant difference in the incidence of mortality,stroke and acute coronary syndrome.Conclusion：ID is a strong,independent marker of impaired prognosis in patients with CHF.