Анемический синдром у пациентов с хронической сердечной недостаточностью


Напалков Д.А., Панферов А.С.

Причины снижения уровня гемоглобина у пациентов с хронической сердечной недостаточностью (ХСН) многочисленны и разнообразны. В качестве возможных причин снижения уровня гемоглобина при ХСН рассматривают нарушения функции почек (кардиоренальный анемический синдром); гемодилюцию; дефицит железа, связанный с хронической кровопотерей на фоне приема антитромботических препаратов; применение ингибиторов ангиотензинпревращающего фермента и антагонистов рецепторов ангиотензина II; активацию провоспалительных цитокинов и связанную с ней дисфункцию костного мозга. Многообразие причин, приводящих к снижению уровня гемоглобина у пациентов с ХСН, делает затруднительным выбор лечебной тактики. В качестве возможных методов лечения анемии у пациентов с ХСН рассматривается применение препаратов железа (преимущественно внутривенно), препаратов эритропоэтина и их сочетание.

Литература


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