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Кардиология

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Анемия и железодефицит у больных с хронической сердечной недостаточностью

https://doi.org/10.18087/cardio.2638

Полный текст:

Аннотация

В представленном обзоре затронуты вопросы распространенности анемии и железодефицита (ЖД) при ХСН, их влияние на течение и прогноз этого состояния. Сформулировано определение анемии и ЖД на основе оценки различных лабораторных данных. В частности, обсуждается диагностическая значимость определения сывороточного железа, ферритина сыворотки крови, коэффициента насыщения трансферрина, общей железосвязывающей способности сыворотки крови и уровень растворимых рецепторов трансферрина. Подчеркивается важность определения уровня железа в костном мозге, хоть и являющегося «золотым стандартом» диагностики ЖД, но редко используемого в широкой клинической практике. Освещены патогенетические механизмы развития ЖД при ХСН, включая недостаток поступления железа, роль воспаления, эритропоэтина, РААС и влияние некоторых фармакологических препаратов. Описываются физиологические последствия ЖД и анемии, активация гемодинамических и негемодинамических компенсаторных механизмов, развивающихся в ответ на анемию и нередко усугубляющих течение ХСН. Особое внимание уделено современным подходам в лечении анемии и ЖД при ХСН, включая обсуждение эффективности и безопасности пероральных, внутривенно вводимых препаратов железа и стимуляторов гемопоэза.

Об авторах

Н. Т. Ватутин
«ДонНМУ им. М. Горького» МЗ Украины
Украина
83003, Донецк, пр-кт Ильича, д. 16


Г. Г. Тарадин
«ДонНМУ им. М. Горького» МЗ Украины
Украина
83003, Донецк, пр-кт Ильича, д. 16


И. В. Канишева
«ДонНМУ им. М. Горького» МЗ Украины
Украина
83003, Донецк, пр-кт Ильича, д. 16


В. В. Венжега
«ДонНМУ им. М. Горького» МЗ Украины
Украина
83003, Донецк, пр-кт Ильича, д. 16


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Для цитирования:


Ватутин Н.Т., Тарадин Г.Г., Канишева И.В., Венжега В.В. Анемия и железодефицит у больных с хронической сердечной недостаточностью. Кардиология. 2019;59(4S):4-20. https://doi.org/10.18087/cardio.2638

For citation:


Vatutin N.T., Taradin G.G., Kanisheva I.V., Venzheha V.V. Anaemia and iron deficiency in chronic heart failure patients. Kardiologiia. 2019;59(4S):4-20. (In Russ.) https://doi.org/10.18087/cardio.2638

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