补充和耗尽铁对缺氧肺高血压的影响:两项随机对照试验
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
概括
补充铁可以降低高海拔肺高血压,而缺铁会使其恶化. 这项研究研究了铁的可用性对高度诱导的低氧性肺高血压对健康个体和慢性山病患者的影响.
科学领域:
- 生理学 生理学 生理学
- 高度医学 高度医学
- 心血管研究研究心血管研究
背景情况:
- 缺氧是肺高血压在呼吸条件和高海拔地区的主要驱动因素.
- 铁状况对缺氧诱导的肺动脉压的影响,可能是通过缺氧诱导因素,尚未完全理解.
- 肺高血压中铁缺氧相互作用的病理生理学和临床意义尚不清楚.
研究的目的:
- 调查调节铁的可用性是否会影响高度引起的缺氧性肺高血压.
- 评估补充和耗尽铁对低氧条件下的肺动脉静脉压的影响.
主要方法:
- 两项随机,双盲,安慰剂控制的研究在高海拔 (4340米) 进行.
- 协议1:健康的男性在缺氧的一周内接受铁或安慰剂输液.
- 方案2:患有慢性山病的患者接受了血液去除 (静脉切除) 以诱导铁缺乏症,随后输注铁或安慰剂.
主要成果:
- 在健康人群中,补充铁可逆转约40%的低氧性肺高血压反应,降低肺动脉静脉压 (PASP) 6 mm Hg.
- 慢性山病患者的静脉切割诱导的铁缺乏症增加了PASP约25% (9毫米升).
- 在慢性山病协议中,在交叉阶段没有观察到铁替代的急性影响.
结论:
- 补充铁可以减轻低毒性肺高血压.
- 缺铁似乎会加剧低氧性肺高血压.
- 铁的可用性是高度引起的肺高血压的发展和严重性的重要因素.
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