慢性阻塞性肺疾病患者贫血原因探讨_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 刘颖 , 高元勋

Corresponding author：

刘颖, Email: refresh2008@126.com

Keywords：

慢性阻塞性肺疾病; 贫血; 促红细胞生长素; C反应蛋白

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目的探讨稳定期COPD 患者贫血的原因。方法选择稳定期COPD 患者60 例, 测定其Hb、C 反应蛋白( CRP) 、促红细胞生成素( EPO) 、肺功能、身高和体重, 计算体重指数( BMI) 。根据Hb 浓度分为贫血组和非贫血组, 比较两组CRP、EPO、肺功能损害程度、BMI 的差异。结果贫血组8例, 非贫血组52 例, 贫血发生率为13. 3% 。贫血组CRP 和EPO 水平显著高于非贫血组[ ( 20. 46 ±9. 43) mg/L比( 13. 75 ±2. 14) mg/L, ( 28. 7 ±5. 2) U/L 比( 14. 7 ±4. 5) U/L, P 均 lt;0. 05] , 肺功能和BMI 在两组之间无显著差异( P gt;0. 05) 。贫血组的EPO 与CRP 水平呈明显负相关( r = - 0. 918, P lt;0. 01) , 这种相关性在非贫血组中不存在( P gt; 0. 2) 。结论 COPD 患者发生贫血可能与慢性炎症及EPO 抵抗有关。

Citation： 刘颖,高元勋. 慢性阻塞性肺疾病患者贫血原因探讨. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(3): 285-286. doi: Copy

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1. KimV, Rogers TJ, Criner GJ. New concepts in the pathobiology of chronic obstructive pulmonary disease. Proc AmThorac Soc, 2008, 5:478-485.
2. Macdougall IC, Cooper AC. Hyporesponsiveness to erythropoietic therapy due to chronic inflammation. Eur J Clin Invest, 2005, 35( Suppl 3) : S32-S35.
3. Hanriot D, Bello G, Ropars A, et al. C-reactive protein induces proand anti- inflammatory effects, inducing activation of the liver X receptor alpha, on human monocytes. Thromb Haemost, 2008 , 99 :558-569.
4. Karadag F, Kirdar S, Karul AB, et al. The value of C-reactive protein as a marker of systemic inflammation in stable chronic obstructive pulmonary disease. Eur J Intern Med, 2008, 19: 104-108.
5. van der Putten K, Braam B, Jie KE, et al. Mechanisms of Disease:erythropoietin resistance in patients with both heart and kidney failure. Nat Clin Pract Nephrol, 2008 , 4: 47 -57.
6. Means RT Jr. Advances in the anemia of chronic disease. Int J Hematol, 1999, 70: 7-12.
7. Jacober ML, Mamoni RL, Lima CS, et al. Anaemia in patients with cancer: role of inflammatory activity on iron metabolism and severity of anaemia. Med Oncol, 2007, 24: 323-329.
8. Balla J, Jeney V, Varga Z, et al. Iron homeostasis in chronic inflammation. Acta Physiol Hung, 2007, 94: 95-106.
9. Semrin G, Fishman DS, Bousvaros A, et al. Impaired intestinal iron absorption in Crohn′s disease correlates with disease activity and markers of inflammation. InflammBowel Dis, 2006, 12: 1101-1106.

Chinese Journal of Respiratory and Critical Care Medicine

慢性阻塞性肺疾病患者贫血原因探讨

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