PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media278980ArticlesСтатьиANEMIC SYNDROME IN PATIENTS WITH CHRONIC HEART FAILUREАНЕМИЧЕСКИЙ СИНДРОМ У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮNapalkovDmitriy AleksandrovichНапалковДмитрий Александрович

ГОУ ВПО Первый МГМУ имени И.М. Сеченова Минздравсоцразвития РФ

PanferovA SПанферовА С

ГОУ ВПО Первый МГМУ имени И.М. Сеченова Минздравсоцразвития РФ

NapalkovD APanferovA SГОУ ВПО Первый МГМУ имени И.М. Сеченова Минздравсоцразвития РФ150820111815NO15 (2011)№15 (2011)353924022023Copyright ©; 2011, Bionika MediaCopyright ©; 2011, ООО «Бионика Медиа»2011Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/278980

The reasons for reduction of hemoglobin level in patients with chronic heart failure (CHF) are numerous and varied. Possible causes of the decrease in hemoglobin level in CHF are decreased kidney function (cardio-renal anemia syndrome); hemodilution; iron deficiency associated with chronic blood loss against the background of application of antiplatelet drugs; the use of angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists; activation of pro-inflammatory cytokines and associated bone marrow dysfunction. The variety of causes leading to a decrease in hemoglobin level in patients with CHF makes difficult a choice of treatment tactics. As a possible method of treatment of anemia in patients with CHF, the use of iron preparations (especially intravenous), EPO and their combination is considered.

Причины снижения уровня 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.

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