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铁疗法对慢性心力衰竭和缺铁性贫血的影响:一项系统评价和荟萃分析。

Iron therapy effect on chronic heart failure and iron-deficiency anemia: a systematic review and meta-analysis.

作者信息

Pintaningrum Yusra, Yunandari Ni Putu

机构信息

Cardiology and Vascular Department, Faculty of Medicine and Health Science, Mataram University, Mataram, Indonesia.

Faculty of Medicine and Health Science, Mataram University, Mataram, Indonesia.

出版信息

Egypt Heart J. 2024 Aug 30;76(1):116. doi: 10.1186/s43044-024-00545-8.

Abstract

BACKGROUND

Heart failure complicated with iron deficiency is associated with impaired functional capacity, poor quality of life, increased hospitalization, and mortality. This systematic review and meta-analysis were conducted to assess the effect of oral and intravenous iron therapy on functional capacity, hospitalization risk, and mortality risk in patients with chronic heart failure and iron-deficiency anemia.

METHODS

Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on Cochrane Library, PubMed Central, and Medline databases published in the last 20 years. Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles.

RESULTS

Based on the meta-analysis of included studies, the analytical results of intravenous iron therapy in patient with chronic heart failure and iron-deficiency anemia showed there is 30.82 (MD = 30.82: 95% CI 18.23-43.40) meter change in patient 6MWT, there is likelihood of 0.55 times (55%) (RR = 0.45: 95% CI 0.30-0.68) lower risk of hospitalization and lower risk of mortality (RR = 0.18: 95% CI 0.04-0.78), because heart failure worsening both with statistically significant overall effect compared with placebo.

CONCLUSIONS

There is statistically significant effect of intravenous iron therapy to improve patient functional capacity and reduce likelihood of hospitalization risk of 0.55 times (55%) in patient with chronic heart failure and iron-deficiency anemia.

摘要

背景

心力衰竭合并缺铁与功能能力受损、生活质量差、住院率增加及死亡率升高有关。本系统评价和荟萃分析旨在评估口服和静脉铁剂治疗对慢性心力衰竭合并缺铁性贫血患者功能能力、住院风险及死亡风险的影响。

方法

采用PRISMA(系统评价与荟萃分析优先报告条目)方法在过去20年发表的Cochrane图书馆、PubMed Central和Medline数据库中检索已发表的科学文章。基于纳入的已发表科学文章,使用RevMan 5.4版本进行进一步的系统评价和荟萃分析。

结果

基于纳入研究的荟萃分析,慢性心力衰竭合并缺铁性贫血患者静脉铁剂治疗的分析结果显示,患者6分钟步行试验(6MWT)有30.82米的变化(MD = 30.82:95%CI 18.23 - 43.40),住院风险降低0.55倍(55%)(RR = 0.45:95%CI 0.30 - 0.68),死亡风险降低(RR = 0.18:95%CI 0.04 - 0.78),因为与安慰剂相比,心力衰竭恶化均具有统计学意义的总体效应。

结论

静脉铁剂治疗对改善慢性心力衰竭合并缺铁性贫血患者的功能能力具有统计学意义,且住院风险降低0.55倍(55%)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ab/11364828/e94d912e1271/43044_2024_545_Fig1_HTML.jpg

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