鉄補給と鉄欠乏が低酸素性肺高血圧に及ぼす影響:ランダム化比較試験2件
Thomas G Smith1, Nick P Talbot, Catherine Privat
1Department of Physiology, Anatomy, and Genetics, University of Oxford, Sherrington Bldg, Parks Road, Oxford OX1 3PT, England.
JAMA
|October 8, 2009
まとめ
鉄のサプリメントは,高海拔の肺高血圧を軽減することができますが,鉄の枯渇はそれを悪化させます. この研究では,鉄の供給量の影響が,健康な個体と慢性山病の個体において,標高に起因する低酸素性肺高血圧に及ぼす影響を調査した.
科学分野:
- 生理学 生理学とは
- 高地医学は,高地医学である.
- 心血管研究 循環器科の研究
背景:
- 低酸素症は,呼吸器疾患および高空での肺高血圧の主要な要因です.
- 低酸素誘発性肺動脈圧に対する鉄の状態の影響は,潜在的に低酸素誘発性因子経由で完全に理解されていません.
- 肺高血圧における鉄と低酸素の相互作用の病理生理学的および臨床的意義は不明である.
研究 の 目的:
- 調節鉄の利用可能性が,高 altitude-induced hypoxic pulmonary hypertensionに影響するかどうかを調査する.
- 低酸素状態での肺動脈シストリック圧力に対する鉄補給と鉄欠乏の影響を評価する.
主な方法:
- 2つのランダム化,ダブルブラインド,プラセボ対照試験は,高い標高 (4340 m) で実施されました.
- プロトコル1:健康な男性は,一週間の低酸素期間に鉄またはプラセボを注入した.
- プロトコル2:慢性山岳病の患者は,鉄欠乏症を誘発するために血液の除去 (静脈切開) を受け,その後に鉄またはプラセボの注射を行った.
主要な成果:
- 健康な個体における鉄補給は,低酸素性肺高血圧反応の約40%を逆転させ,肺動脈静脈圧 (PASP) を6mmHg低下させた.
- 慢性山病患者における静脈切開による鉄欠乏症は,PASPを約25% (9mm Hg) 増加させた.
- 慢性山病プロトコルのクロスオーバーフェーズでは,鉄代謝の急性効果は観察されなかった.
結論:
- 鉄の補給は,低酸素性肺高血圧を軽減する可能性があります.
- 鉄の不足は,低酸素性肺高血圧を悪化させるようです.
- 鉄の供給量は,高度に誘発された肺高血圧の発生と重度の重要な要因です.
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