Anemia of Chronic Disease in Chronic Obstructive Pulmonary Disease: A Case-Control Study of Cardiopulmonary Exercise Responses
Anemia of Chronic Disease in Chronic Obstructive Pulmonary Disease: A Case-Control Study of Cardiopulmonary Exercise Responses
复制标题
DOI：
10.1159/000326899
复制
发表时间：
2011-01-01
期刊：
影响因子：
3.7
通讯作者：
Argyropoulou, Paraskevi
中科院分区：
文献类型：
--
作者：
Boutou, Afroditi K.;Stanopoulos, Ioannis;Argyropoulou, Paraskevi
背景：慢性阻塞性肺疾病（COPD）患者可能存在贫血，并进一步损害其功能能力。目的：本研究利用心肺运动试验（CPET）研究慢性阻塞性肺疾病（COPD）患者贫血（ACD）的患病率及其对呼吸困难和运动能力的影响。方法：对283例稳定期COPD患者（男性263例，女性60例，年龄60.31 +/- 5.34岁，1 s用力呼气量百分比46.94 +/- 6.12）进行ACD患病率评估。ACD的诊断是基于临床和实验室参数的结合[血红蛋白（Hb）男性< 13 g/dl，女性< 12 g/dl；铁蛋白> 30 ng/ml；总铁结合能力< 250 μ g/dl，转铁蛋白饱和率在15% ~ 50%之间。27例确诊为ACD的患者（病例）和27例匹配的非贫血患者（对照）完成了最大CPET，并比较两组之间的数据。结果：确诊ACD 29例，患病率10.24%；严重性；贫血一般为轻度（平均血红蛋白：12.19±0.66 g/dl）。与对照组相比，ACD患者的医学研究委员会呼吸困难评分较高（2.78 +/- 0.44比2.07 +/- 0.55,p < 0.001），峰值O-2摄取（VO2）（59.54 +/- 17.17比预测的71.26 +/- 11.85%,p < 0.05），峰值工作率（54.94 +/- 21.42比预测的68.72 +/- 20.81%,p < 0.05）和峰值VO2/心率（69.07 +/- 17.26比预测的82.04 +/- 18.22%,p < 0.05）。0.05)。无氧阈值也有降低的趋势（48.48 +/- 15.16 vs. 55.42 +/- 9.99%预测，p = 0.062）。各组之间没有指示呼吸限制的运动参数差异。结论：ACD发生在大约10%的稳定期COPD患者中，并且在运动时对呼吸困难和循环效率有负面影响。巴塞尔S. Karger股份有限公司版权所有
Background: Anemia may be present in patients with chronic obstructive pulmonary disease (COPD) and further impair their functional capacity. Objectives: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET). Methods: ACD prevalence was assessed in 283 consecutive patients with stable COPD (263 males, 60 females; age 60.31 +/- 5.34 years; percent forced expiratory volume in 1 s 46.94 +/- 6.12). ACD diagnosis was based on a combination of clinical and laboratory parameters [hemoglobin (Hb) < 13 g/dl for males, < 12 g/dl for females; ferritin > 30 ng/ml; total iron-binding capacity < 250 mu g/dl, and transferrin saturation rate between 15 and 50%]. Twenty-seven patients who were identified with ACD (cases) and 27 matched nonanemic patients (controls) completed maximal CPET, and data were compared between the groups. Results: ACD was diagnosed in 29 patients, which represents a prevalence of 10.24%; the severity ;of anemia was generally mild (mean Hb: 12.19 +/- 0.66 g/dl). Patients with ACD had a higher Medical Research Council dyspnea score compared to controls (2.78 +/- 0.44 vs. 2.07 +/- 0.55; p < 0.001) and lower peak O-2 uptake (VO2) (59.54 +/- 17.17 vs. 71.26 +/- 11.85% predicted; p < 0.05), peak work rate (54.94 +/- 21.42 vs. 68.72 +/- 20.81% predicted; p < 0.05) and peak VO2/heart rate (69.07 +/- 17.26 vs. 82.04 +/- 18.22% predicted; p ! 0.05). There was also a trend for a lower anaerobic threshold (48.48 +/- 15.16 vs. 55.42 +/- 9.99% predicted; p = 0.062). No exercise parameter indicative of respiratory limitation differed between the groups. Conclusions: ACD occurs in approximately 10% of stable COPD patients and has a negative impact on dyspnea and circulatory efficiency during exercise. Copyright (C) 2011 S. Karger AG, Basel