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稳定的慢性肠衰竭队列中的缺铁性贫血:患病率、关联因素及结局

Iron deficiency anaemia in a stable chronic intestinal failure cohort: Prevalence, associations and outcomes.

作者信息

Conley Thomas Edward, Kopczynska Maja, Harrison Simon, Lonsdale Henry, Barrett Maria, Lal Simon

机构信息

Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK.

Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK; School of Health Sciences, University of Manchester, Manchester M13 9PL, UK.

出版信息

Clin Nutr ESPEN. 2025 Apr;66:46-50. doi: 10.1016/j.clnesp.2025.01.029. Epub 2025 Jan 10.

Abstract

BACKGROUND & AIMS: Current estimates of the prevalence of iron deficiency anaemia (IDA) in patients with chronic intestinal failure (CIF) exceed those seen in general population, however, the studies to-date are limited. The aim of this study was to determine the point prevalence of IDA in a large cohort of stable home parenteral nutrition (HPN) dependent adults managed by a specialist Intestinal Failure Unit.

METHODS

This was a retrospective cohort study of HPN-dependent adults managed by a national UK IF Reference Centre between 01/01/2019 and 31/12/2019. Patients with IDA were followed up until death or the end of the follow-up on 01/05/2024.

RESULTS

241 patients were included in the analysis. 27/241 (11.2 %) were diagnosed with IDA. Previous hypoferritinaemia, previous IDA and not receiving the recommended amount of iron via parenteral nutrition as per ESPEN guidelines were associated with higher likelihood of IDA diagnosis. Only 2/27 patients with IDA at inclusion fulfilled IDA criteria by the end of the follow up. Long-term outcomes in the patient cohort with IDA were good with no patients displaying evidence of malignancy until the end of the study period.

CONCLUSION

Our study shows that while IDA is common in patients with CIF, its clinical implications may differ from those in the general non-IF population. Further larger collaborative multi-centre research is necessary to confirm these findings with a view to develop evidence-based guidelines for the investigation of IDA in CIF.

摘要

背景与目的

目前对慢性肠衰竭(CIF)患者缺铁性贫血(IDA)患病率的估计高于普通人群,但迄今为止的研究有限。本研究的目的是确定由专业肠衰竭单元管理的大量依赖家庭肠外营养(HPN)的稳定成年患者中IDA的时点患病率。

方法

这是一项对2019年1月1日至2019年12月31日期间由英国国家肠衰竭参考中心管理的依赖HPN的成年患者进行的回顾性队列研究。对IDA患者进行随访,直至死亡或2024年5月1日随访结束。

结果

241例患者纳入分析。241例中有27例(11.2%)被诊断为IDA。既往低铁蛋白血症、既往IDA以及未按照欧洲临床营养与代谢学会(ESPEN)指南通过肠外营养接受推荐量的铁与IDA诊断的较高可能性相关。纳入时IDA的27例患者中只有2例在随访结束时符合IDA标准。IDA患者队列的长期结局良好,直至研究期结束没有患者显示出恶性肿瘤的迹象。

结论

我们的研究表明,虽然IDA在CIF患者中很常见,但其临床意义可能与非肠衰竭普通人群不同。需要进一步开展更大规模的多中心合作研究来证实这些发现,以期制定基于证据的CIF患者IDA调查指南。

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