von Haehling S, Anker S D
Zentrum für Angewandte Kachexieforschung, Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
Dtsch Med Wochenschr. 2014 Apr;139(16):841-4. doi: 10.1055/s-0034-1369988. Epub 2014 Apr 10.
Anaemia and iron deficiency are frequent co-morbidities in patients with chronic heart failure. Both are bound to worsen an already reduced exercise capacity in these patients. Recent data have demonstrated that iron deficiency alone, i.e. without concomitant anaemia, reduces quality of life, exercise capacity and likely also survival. Two clinical entities should be differentiated in this context: absolute and functional iron deficiency, the first being an absolute deficiency of iron, the second representing a disturbed mobilisation capacity. The FAIR-HF study has shown that intravenous iron administration can improve quality of life and exercise capacity in affected patients. A correct diagnosis can easily be arrived at using parameters such as serum ferritin and transferrin saturation. Replenishing iron stores is most useful using the intravenous route, and administered doses need to be adjusted to individual needs.
贫血和缺铁是慢性心力衰竭患者常见的合并症。这两者都会使这些患者本已降低的运动能力进一步恶化。最近的数据表明，仅缺铁（即无合并贫血）就会降低生活质量、运动能力，还可能影响生存率。在这种情况下应区分两个临床实体：绝对性缺铁和功能性缺铁，前者是铁的绝对缺乏，后者代表动员能力紊乱。FAIR-HF研究表明，静脉注射铁剂可改善受影响患者的生活质量和运动能力。使用血清铁蛋白和转铁蛋白饱和度等参数可以很容易地做出正确诊断。通过静脉途径补充铁储备最为有效，给药剂量需要根据个体需求进行调整。
