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铁和铁蛋白对重症监护病房死亡率的影响：一项荟萃分析。

Iron and ferritin effects on intensive care unit mortality: A meta-analysis.

作者信息

Yang Deng-Can, Zheng Bo-Jun, Li Jian, Yu Yi

机构信息

Department of Anesthesiology, The Central Hospital of Shaoyang, Shaoyang 422000, Hunan Province, China.

Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China.

出版信息

World J Clin Cases. 2024 Jun 6;12(16):2803-2812. doi: 10.12998/wjcc.v12.i16.2803.

DOI:10.12998/wjcc.v12.i16.2803
PMID:38899309
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11185325/
Abstract

BACKGROUND

The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.

AIM

To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.

METHODS

Web of Science, Embase, PubMed, and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients. Two reviewers independently assessed, selected, and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients. Data on serum iron or ferritin levels, mortality, and demographics were extracted.

RESULTS

Nineteen studies comprising 125490 patients were eligible for inclusion. We observed a slight negative effect of serum ferritin on mortality in the United States population [relative risk (RR) 1.002; 95%CI: 1.002-1.004). In patients with sepsis, serum iron had a significant negative effect on mortality (RR = 1.567; 95%CI: 1.208-1.925).

CONCLUSION

This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis. Furthermore, it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.

摘要

背景

血清铁或铁蛋白参数对危重症患者死亡率的影响尚未得到充分描述。

目的

确定血清铁或铁蛋白参数与危重症患者死亡率之间的关联。

方法

检索科学网、Embase、PubMed和Cochrane图书馆数据库，查找关于血清铁或铁蛋白参数与危重症患者死亡率的研究。两名评审员独立评估、选择并提取报告血清铁或铁蛋白参数与危重症患者死亡率的研究中的数据。提取血清铁或铁蛋白水平、死亡率和人口统计学数据。

结果

19项研究（共125490名患者）符合纳入标准。我们观察到血清铁蛋白对美国人群的死亡率有轻微负面影响[相对风险（RR）1.002；95%置信区间：1.002 - 1.004]。在脓毒症患者中，血清铁对死亡率有显著负面影响（RR = 1.567；95%置信区间：1.208 - 1.925）。

结论

本系统评价提供了脓毒症患者血清铁水平与死亡率之间负相关的证据。此外，它揭示了血清铁蛋白对美国人群死亡率有轻微但不利的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/34a827ddcd4a/WJCC-12-2803-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/a84e90d8b6b7/WJCC-12-2803-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/1098783f1ee1/WJCC-12-2803-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/d49b90fab00a/WJCC-12-2803-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/4a334ae94ac1/WJCC-12-2803-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/18f51b0e0567/WJCC-12-2803-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/34a827ddcd4a/WJCC-12-2803-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/a84e90d8b6b7/WJCC-12-2803-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/1098783f1ee1/WJCC-12-2803-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/d49b90fab00a/WJCC-12-2803-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/4a334ae94ac1/WJCC-12-2803-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/18f51b0e0567/WJCC-12-2803-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11185325/34a827ddcd4a/WJCC-12-2803-g006.jpg

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本文引用的文献

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Iron Homeostasis and Metabolism: Two Sides of a Coin.铁稳态和代谢：一枚硬币的两面。
Adv Exp Med Biol. 2021;1301:25-40. doi: 10.1007/978-3-030-62026-4_3.
2
Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19.入院时铁蛋白水平升高可预测新冠肺炎患者在重症监护病房的死亡率。
Med Clin (Engl Ed). 2021 Apr 9;156(7):324-331. doi: 10.1016/j.medcle.2020.11.015. Epub 2021 Apr 1.
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Iron homeostasis and disorders revisited in the sepsis.重新探讨脓毒症中的铁稳态和铁代谢紊乱。
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Prediction of Poor Outcomes for Septic Children According to Ferritin Levels in a Middle-Income Setting.中低收入环境下根据铁蛋白水平预测脓毒症儿童不良预后。
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