郎彬燕,郑舒展

铁缺乏是心力衰竭常见的独立预后危险因素，患病率高达37%~61%。慢性炎症通过IL-6/JAK/STAT3通路上调铁调素，诱导功能性铁缺乏，导致心肌线粒体功能障碍及ATP合成减少，并可触发铁死亡，加速心室重构。目前诊断标准基于血清铁蛋白及转铁蛋白饱和度，但难以准确反映心肌铁状态。静脉补铁（尤其是羧基麦芽糖铁）可改善症状、生活质量并降低心衰住院风险，获指南推荐。未来靶向铁调素及铁死亡抑制剂的精准治疗值得深入探索。

心力衰竭；铁缺乏；静脉补铁；铁死亡；心肌能量代谢

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