Int J Cardiol:铁缺乏对心力衰竭住院患者长期临床结局的影响!

2018-03-11 xing.T MedSci原创

由此可见,出院时绝对的ID,而不是FID,与1年死亡率或HHF患者在入院风险增加有关。需要进一步的研究来评价补铁对HHF患者临床结局的影响。

慢性心力衰竭(HF)患者铁缺乏(ID)较为常见,并与较差的临床结局相关。而ID在住院的心力衰竭(HHF)患者中更为常见,但是其对HHF患者长期预后的影响尚不清楚。

近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章。研究人员评估了578例HHF患者出院时的铁状态。绝对ID被定义为血清铁蛋白<100 μg/L,以及功能性ID(FID)被定义为血清铁蛋白在100-299μg/L,转铁蛋白饱和度<20%。感兴趣的主要结局是一年内全因死亡和HF住院的复合事件。

在研究人群中,185例患者存在绝对的ID,88例患者存在FID和305例患者没有ID的证据。出院后一年,64名患者死亡,112名患者因HF再入院。绝对ID的患者发生了更多的不良事件,相比于FID或没有ID(P=0.021)的患者。在多变量Cox回归分析中,绝对的ID与一年的不良事件风险增加显著相关(风险比为1.50,95%可信区间为1.02-2.21,P=0.040),与其余患者相比。敏感性分析表明患者预后并没有受不同贫血状态的影响,无论是射血分数降低还是正常的HF患者中(分别有相互作用的P=0.17和0.68)。

由此可见,出院时绝对的ID,而不是FID,与1年死亡率或HHF患者在入院风险增加有关。需要进一步的研究来评价补铁对HHF患者临床结局的影响。

原始出处:

Hiroki Nakano, et al. Impact of iron deficiency on long-term clinical outcomes of hospitalized patients with heart failure.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.03.039

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  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-12 龙胆草

    学习谢谢分享

    0

  6. 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createdBy=71072289279, createdName=121e1b00m28暂无昵称, createdTime=Mon Mar 12 01:05:48 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295323, encodeId=03fd29532337, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Mar 12 00:05:27 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295315, encodeId=4e7b295315f7, content=好厉害的统计.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-12 yfjms

    学习

    0

  7. 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createdBy=71072289279, createdName=121e1b00m28暂无昵称, createdTime=Mon Mar 12 01:05:48 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295323, encodeId=03fd29532337, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Mar 12 00:05:27 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295315, encodeId=4e7b295315f7, content=好厉害的统计.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-12 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1781886, encodeId=e9651e81886de, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Tue Jul 10 16:02:00 CST 2018, time=2018-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843155, encodeId=4aae18431557a, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, 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createdBy=71072289279, createdName=121e1b00m28暂无昵称, createdTime=Mon Mar 12 01:05:48 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295323, encodeId=03fd29532337, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Mar 12 00:05:27 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295315, encodeId=4e7b295315f7, content=好厉害的统计.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-12 121e1b00m28暂无昵称

    学习新知识.谢谢

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1781886, encodeId=e9651e81886de, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Tue Jul 10 16:02:00 CST 2018, time=2018-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843155, encodeId=4aae18431557a, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, 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channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Mar 12 07:46:25 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295384, encodeId=ded729538455, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Mon Mar 12 06:45:38 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295344, encodeId=87242953445b, content=学习新知识.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=71072289279, createdName=121e1b00m28暂无昵称, createdTime=Mon Mar 12 01:05:48 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295323, encodeId=03fd29532337, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Mar 12 00:05:27 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295315, encodeId=4e7b295315f7, content=好厉害的统计.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-12 明月清辉

    谢谢分享.学习了

    0

  10. 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channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Mar 12 07:46:25 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295384, encodeId=ded729538455, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Mon Mar 12 06:45:38 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295344, encodeId=87242953445b, content=学习新知识.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=71072289279, createdName=121e1b00m28暂无昵称, createdTime=Mon Mar 12 01:05:48 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295323, encodeId=03fd29532337, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Mar 12 00:05:27 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295315, encodeId=4e7b295315f7, content=好厉害的统计.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 11 23:32:35 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-11 惠映实验室

    好厉害的统计.学习了.

    0

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2018年2月,欧洲肿瘤内科学会(ESMO)发布了癌症患者贫血和铁缺乏的管理指南。贫血和缺铁是实体肿瘤和血液恶性肿瘤,尤其是接受化疗药物治疗患者最常见的并发症,本文主要针对贫血的评估以及补铁治疗方法提出指导建议,主要目的是优化癌症患者贫血和铁缺乏的管理。

重视癌症患者贫血,早期筛查与治疗铁缺乏——欧洲《成年癌症患者铁缺乏的管理意见书》解读

贫血是肿瘤患者常见的并发症,而铁缺乏是其最常见的病因之一。本文对欧洲肿瘤及血液学专家组2017 年发布的《成年癌症患者铁缺乏的管理意见书》进行了解读,并与国内外肿瘤相关贫血指南、既往文献进行对比与总结,重点强调:应在癌症患者中早期定期评估和监测铁参数,早期识别和治疗贫血,以促红细胞生成类药物和铁剂补充作为绝对性铁缺乏和功能性缺铁的治疗基石,减少不必要的输血。

Anaesth Intensive Care:全麻下超快速输入铁麦芽糖治疗铁缺乏是安全的

本研究旨在评估全麻期间超快速(15分钟)输入铁麦芽糖对治疗铁缺乏患者的有效性和安全性。研究人员进行了一项前瞻性干预非随机研究,共纳入了99名缺铁有或无贫血表现的成人患者。在超过15分钟的麻醉维持阶段,如果不贫血患者输入500毫克铁麦芽糖,贫血则输入1000毫克。六周评估患者的血流动力学稳定性,立即或延迟铁相关的副作用和疗效。铁麦芽糖输入前中后明显地低血压或血管加压素的需求并无明显差异。术中无严重并

Eur J Heart Fail:羧麦芽糖铁对铁缺乏心衰患者住院率和死亡率的影响!

由此可见,静脉注射FCM治疗与伴有ID的心衰患者再次CV住院治疗减少有关。