| Objective: Chronic heart failure is a syndrome of heart filling and(or)impaired ejection capacity in a variety of structural or functional heart diseases.Heart failure is the leading cause of death in the majority of cardiovascular diseases,and its prevalence is high.Ventricular remodeling is the basic mechanism of the development of heart failure.Myocardium by various exogenous or endogenous factors after injury,sympathetic nervous system and renin angiotensin aldosterone system(RASS)is activated,neuroendocrine and cytokines,inflammatory factors of endogenous activated;and promoting myocardial remodeling,worsen myocardial damage and cardiac function.Therefore,the treatment of chronic heart failure has been from short-term hemodynamic,pharmacological measures to long-term,repair strategy,established the principle of neuroendocrine inhibitor based treatment.The goal is not only to improve the symptoms and improve the quality of life,but also to prevent and delay the development of myocardial remodeling,which can reduce the hospitalization rate and mortality of patients with heart failure.A large part of clinical anemia is caused by chronic diseases of the blood system outside,usually the primary disease and(or)with symptoms and signs of disease will cover anemia(such as autoimmune diseases,cancer,heart disease and so on),so only by the anemia caused by heart change is often misdiagnosis but,this often becomes the reason of the state of the primary disease exacerbations and poor treatment of the clinical manifestations of anemia;individual differences is large,generally no obvious symptoms of mild anemia,moderate anemia can have different degrees of heart palpitations,shortness of breath,dyspnea,can lead to angina pectoris.Anemia in patients with echocardiography can show the heart generally increased,left atrioventricular valve regurgitation,cardiac function as reflected in the most valuable indicators of stroke volume(SV),left ventricular ejection fraction(LVEF)was normalor even more than normal,this is the fundamental difference between anemia and other causes of heart change.This study through the observation of chronic heart failure(chronic heart failure,CHF)level of serum ferritin(serum ferritin,SF),serum iron(IRON),total iron binding capacity(total iron binding capacity,TIBC)and hemoglobin(hemoglobin,Hb)level,to understand the relationship between anemia and CHF,to explore its clinical value.Methods: From December 2014 to July 2015,106 patients in our department were divided into CHF group(n=68)and control group(n=38).According to CHF group,the NYHA group was divided into group NYHAII(n=12),group NYHAIII(n=30)and group NYHAIV(n=26).CHF group according to whether the anemia is divided into anemia group(n=36)and non anemia group(n=32).All patients were admitted to hospital on the day of ML 2-3 venous blood test BNP level,the next morning fasting blood samples ml SF 2-3,IRON,TIBC,Hb levels.Left ventricular diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by color Doppler echocardiography.Comparison of SF,IRON,TIBC,Hb and the incidence of anemia,iron deficiency incidence among the changes in each group,the SF,IRON levels were correlated with Hb,LVEDD,LVEF correlation analysis.Multivariate analysis of risk factors in patients with CHF.Left ventricular diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by color Doppler echocardiography.Comparison of SF,IRON,TIBC,Hb and the incidence of anemia,iron deficiency incidence among the changes in each group,the SF,IRON levels were correlated with Hb,LVEDD,LVEF correlation analysis.Statistical analysis of patients with general information and records of patients with anemia indicators,iron metabolism indicators and other related data.Using SPSS 20 software for data analysis,P<0.05 for the difference was statistically significant.Results: 1.The general data of patients in the two groups,left ventricular ejection fraction and left ventricular end diastolic diameter were statistically significant difference(P<0.05),the two groups in gender,age,weight,high density lipoprotein,lowdensity lipoprotein,cholesterol,glomerular filtration rate was no significant difference(P>0.05).2.Comparison of two groups of anemia data index in hemoglobin and the incidence of anemia and iron deficiency incidence were statistically significant difference(P<0.05),the two groups in the serum ferritin,serum iron,total iron binding capacity,mean corpuscular volume is not statistically significant.3.Serum ferritin levels with heart failure exacerbation decreased in the control group and there were significant differences between NYHA IV group(P<0.05);serum iron levels with heart failure exacerbation decreased in the control group and the observation group were between the heart function in II group,III group,IV group,in the observation group the heart function in II group and IV group,NYHA III group and IV group have significant difference(P<0.05);hemoglobin levels decreased with the aggravation of heart failure in the control group,there were significant differences between respectively and the heart function in II group,III group,IV group(P<0.05);serum iron levels with heart failure exacerbation decreased in the control group and the observation group were between the heart function in II group,III group,IV group,in the observation group the heart function in II group and IV group,NYHA III group and IV group have significant difference(P<0.05);(4)the incidence of anemia in CHF patients with exacerbation of heart failure increased in the control group there were significant differences between respectively and the heart function in II group,III group,IV group;(5)the incidence of iron deficiency There was a significant difference between the control group and the III group,the IV group and the II group and the III group in the cardiac function group(P<0.05).4.Serum iron,serum ferritin levels in the anemia group was significantly lower than in the non anemia group(P<0.05),the incidence of iron deficiency in the anemia group was significantly higher than that in the non anemia group(P<0.05).5.Hemoglobin as a risk factor for predicting the prognosis of patients with CHF(OR=1.073,P=0.045).Conclusion:1.CHF protein in patients with serum iron,serum iron,hemoglobin levels were lower than the control group,and increased with the aggravation of heart failure;the incidence of iron deficiency in CHF group was significantly higher than the control group,and the degree of heart failure was positively correlated with.Therefore,early detection of iron metabolism in patients with CHF is helpful for the treatment of CHF patients with anemia.2.Hemoglobin levels can be one of the risk factors for predicting the prognosis of patients with chronic heart failure. |
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