铁缺乏对慢性心力衰竭患者运动能力和预后的影响

Influence of iron deficiency on the motor ability and prognosis of patients with chronic heart failure

目的探讨慢性心力衰竭患者铁缺乏与运动能力和临床预后的关系。方法前瞻性分析本院自2019年1月至2020年6月286例住院慢性心力衰竭患者的临床资料,根据有无缺铁分为铁缺乏组和非缺铁组,分析比较两组心功能、运动能力差异,并比较两组临床预后的差异。结果与非缺铁组相比,铁缺乏组NT-proBNP升高、E/A降低、LVEDD值升高,NYHAⅡ级患者比例少、NYHAⅣ级患者比例多;HFpEF比例少、HFrEF比例多;6MWT、VO_(2max)、VO_(2max)/Kg低,差异有统计学意义(P<0.05)。铁缺乏组1年内因心衰再住院人数多,差异有统计学意义(P<0.05)。结论铁缺乏将导致慢性心力衰竭患者心功能恶化,运动能力降低,临床预后差,需注意慢性心力衰竭患者铁蛋白水平。

Objective To investigate the association of iron deficiency with the motor ability and prognosis of patients with chronic heart failure.Methods A prospective analysis was performed for the clinical data of 286 patients with chronic heart failure who were hospitalized in our hospital from January 2019 to June 2020,and according to the presence or absence of iron deficiency,they were divided into iron deficiency group and non-iron deficiency group.The two groups were compared in terms of cardiac function,motor ability,and prognosis.Results Compared with the noniron deficiency group,the iron deficiency group had a significant increase in N-terminal pro-brain natriuretic peptide,a significant reduction in mitral ratio of peak early to late diastolic filling velocity,and a significant increase in left ventricular end-diastolic diameter;as for cardiac function,the iron deficiency group had a significantly lower proportion of patients with NYHA grade II cardiac function and a significantly higher proportion of patients with NYHA grade IV cardiac function;as for the type of heart failure,the iron deficiency group had a significantly lower proportion of patients with heart failure with preserved ejection fraction and a significantly higher proportion of patients with heart failure with reduced ejection fraction;as for motor ability,the iron deficiency group had a significantly shorter distance in six-minute walk test and significantly shorter VO_(2max)and VO_(2max)/kg(P<0.05).Compared with the non-iron deficiency group,the iron deficiency group had a significantly higher number of patients readmitted due to heart failure within 1 year(P<0.05).Conclusion Iron deficiency may lead to the deterioration of cardiac function,a reduction in motor ability,and a poor prognosis in patients with chronic heart failure,and the level of ferritin should be monitored for such patients.