Paul Sara, Paul Richard V
Heart Function Clinic, Western Piedmont Heart Centers, Hickory, NC 28602, USA.
J Cardiovasc Nurs. 2004 Nov-Dec;19(6 Suppl):S57-66. doi: 10.1097/00005082-200411001-00008.
Despite advances in the treatment of heart failure (HF) over the past decade, the prognosis remains poor. Anemia is a well-recognized comorbidity in many chronic conditions, but its role in HF has only recently been recognized. Anemia is significantly related to symptoms, exercise capacity, and prognosis in HF; it has been identified as an independent risk factor for mortality in those with left ventricular dysfunction. When HF patients have concomitant renal disease, they invariably become anemic owing to erythropoietin deficiency. In chronic HF patients without renal disease, erythropoietin levels may be elevated in response to anemia, but not adequately increased to overcome it. Some degree of erythropoietin resistance may also be present because of elevated plasma levels of cytokines. Several studies in anemic HF patients have shown positive outcomes using erythropoietin and iron supplementation therapy to increase hemoglobin concentrations to more normal levels. This article reviews the current information available regarding anemia in HF and discusses the clinical implications and treatment of this syndrome.
尽管在过去十年中心力衰竭（HF）的治疗取得了进展，但其预后仍然很差。贫血是许多慢性疾病中一种公认的合并症，但其在HF中的作用直到最近才被认识到。贫血与HF的症状、运动能力和预后密切相关；它已被确定为左心室功能障碍患者死亡的独立危险因素。当HF患者合并肾脏疾病时，由于促红细胞生成素缺乏，他们 invariably 会出现贫血。在没有肾脏疾病的慢性HF患者中，促红细胞生成素水平可能会因贫血而升高，但不足以克服贫血。由于细胞因子血浆水平升高，也可能存在一定程度的促红细胞生成素抵抗。几项针对贫血HF患者的研究表明，使用促红细胞生成素和铁补充疗法将血红蛋白浓度提高到更正常的水平可取得积极结果。本文综述了目前有关HF中贫血的可用信息，并讨论了该综合征的临床意义和治疗方法。
