Anemia in Chronic Obstructive Pulmonary Disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHEN Hong , DENG jia ,  FENG Yulin

West China Hospital SICHUAN University;

Corresponding author：

FENG Yulin, Email: feng_yulin@sina.com

Keywords：

Anemia; Chronic Obstructive Pulmonary Disease

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COPD 是一种可预防、可治疗, 以气流不完全可逆受限并呈进行性发展为特征的疾病, 与肺部对有害气体或有毒颗粒的异常炎症反应有关。在全球范围内COPD 是引起死亡
和功能致残的主要疾病之一。COPD 在全球患病率和死亡率位居第四, 并呈不断上升的趋势[1] 。本病具有明显的肺外效应, 包括引起全身系统性炎症、代谢改变、神经激素激活,以及对肌肉骨骼、心血管系统等其他系统的影响等[2] 。既往认为COPD 仅引起红细胞增多, 但近期研究发现COPD 引起的系统性炎症可影响红细胞的生成, 贫血亦同样存在于部分COPD 患者。目前认为, COPD导致的贫血与其他许多慢性疾病如慢性心衰一样, 同属于一种慢性病性贫血( anemia of chronic disease, ACD) , 称为COPD 相关性贫血, 其患病率高于继发性红细胞增多症在COPD 的患病率[3-5] 。本文就COPD 相关性贫血的流行病学概况、病理生理机制、临床重要性及干预的最新研究进展如下综述。

Citation： CHEN Hong,DENG jia,FENG Yulin. Anemia in Chronic Obstructive Pulmonary Disease. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(6): 606-608. doi: Copy

1.	Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 2007, 166: 532-555.
2.	Agusti AG, Noguera A, Sauleda J, et al. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J , 2003, 21: 347-360.
3.	Similowski T, Agusti A, MacNee W, et al. The potential impact of anaemia of chronic disease in COPD. Eur Respir J , 2006, 27: 390-396.
4.	Chambellan A, Chailleux E, Similowski T, et al. Prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy. Chest, 2005, 128: 1201-1208.
5.	John M, Hoernig S, Doehner W, et al. Anemia and inflammation in COPD. Chest, 2005, 127: 825-829.
6.	John M, Lange A, Hoernig S, et al. Prevalence of anemia in chronic obstructive pulmonary disease: comparison to other chronic diseases. Int J Cardiol, 2006, 111: 365-370.
7.	Shorr AF, Doyle J, Stern L, et al. Anemia in chronic obstructive pulmonary disease: epidemiology and economic implications. Curr Med Res Opin, 2008, 24: 1123-1130 .
8.	Cote C, Zilberberg MD, Mody SH, et al. Haemoglobin level and its clinical impact in a cohort of patients with COPD. Eur Respir J ,2007, 29: 923-929.
9.	van der Meer P, Voors AA, Lipsic E, et al. Erythropoietin in cardiovascular diseases. Eur Heart J , 2004 , 25: 285 -291.
10.	Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ ERS position paper.Eur Respir J , 2004, 23: 932-946.
11.	Gan WQ, Man SF, Senthilselvan A, et al. Association between chronic obstructive pulmonary disease and systemic inflammation: asystematic review and a metaanalysis. Thorax , 2004 , 59 : 574 -580.
12.	Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med, 2005, 352: 1011-1023.
13.	Ludwiczek S, Aigner E, Theurl I, et al. Cytokine-mediated regulation of iron transport in human monocytic cells. Blood , 2003 ,101: 4148-4154.
14.	Torti FM, Torti SV. Regulation of ferritin genes and protein. Blood ,2002, 99: 3505-3516.
15.	Kalra PR, Bolger AP, Francis DP, et al. Effect of anemia on exercise tolerance in chronic heart failure in men. Am J Cardiol, 2003, 91 :888-891.
16.	Schonhofer B, Wenzel M, Geibel M, et al. Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease. Crit Care Med, 1998, 26: 1824-1828.
17.	Schonhofer B, Bohrer H, Kohler D. Blood transfusion facilitating difficult weaning from the ventilator. Anaesthesia,1998, 53: 181-184.
18.	Emtner M, Porszasz J, Burns M, et al. Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med, 2003, 168 :1034-1042.
19.	Barreiro E, de la Puente B,Minguella J, et al. Oxidative stress and respiratory muscle dysfunction in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2005, 171: 1116 -1124.
20.	Tsantes A, Bonovas S, Tassiopoulos S, et al. A comparative study of the role of erythropoietin in the pathogenesis of deficient erythropoiesis in idiopathic pulmonary fibrosis as opposed to chronic obstructive pulmonary disease. Med Sci Monit, 2005, 11: CR177-CR181.

1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 2007, 166: 532-555.
2. Agusti AG, Noguera A, Sauleda J, et al. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J , 2003, 21: 347-360.
3. Similowski T, Agusti A, MacNee W, et al. The potential impact of anaemia of chronic disease in COPD. Eur Respir J , 2006, 27: 390-396.
4. Chambellan A, Chailleux E, Similowski T, et al. Prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy. Chest, 2005, 128: 1201-1208.
5. John M, Hoernig S, Doehner W, et al. Anemia and inflammation in COPD. Chest, 2005, 127: 825-829.
6. John M, Lange A, Hoernig S, et al. Prevalence of anemia in chronic obstructive pulmonary disease: comparison to other chronic diseases. Int J Cardiol, 2006, 111: 365-370.
7. Shorr AF, Doyle J, Stern L, et al. Anemia in chronic obstructive pulmonary disease: epidemiology and economic implications. Curr Med Res Opin, 2008, 24: 1123-1130 .
8. Cote C, Zilberberg MD, Mody SH, et al. Haemoglobin level and its clinical impact in a cohort of patients with COPD. Eur Respir J ,2007, 29: 923-929.
9. van der Meer P, Voors AA, Lipsic E, et al. Erythropoietin in cardiovascular diseases. Eur Heart J , 2004 , 25: 285 -291.
10. Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ ERS position paper.Eur Respir J , 2004, 23: 932-946.
11. Gan WQ, Man SF, Senthilselvan A, et al. Association between chronic obstructive pulmonary disease and systemic inflammation: asystematic review and a metaanalysis. Thorax , 2004 , 59 : 574 -580.
12. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med, 2005, 352: 1011-1023.
13. Ludwiczek S, Aigner E, Theurl I, et al. Cytokine-mediated regulation of iron transport in human monocytic cells. Blood , 2003 ,101: 4148-4154.
14. Torti FM, Torti SV. Regulation of ferritin genes and protein. Blood ,2002, 99: 3505-3516.
15. Kalra PR, Bolger AP, Francis DP, et al. Effect of anemia on exercise tolerance in chronic heart failure in men. Am J Cardiol, 2003, 91 :888-891.
16. Schonhofer B, Wenzel M, Geibel M, et al. Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease. Crit Care Med, 1998, 26: 1824-1828.
17. Schonhofer B, Bohrer H, Kohler D. Blood transfusion facilitating difficult weaning from the ventilator. Anaesthesia,1998, 53: 181-184.
18. Emtner M, Porszasz J, Burns M, et al. Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients. Am J Respir Crit Care Med, 2003, 168 :1034-1042.
19. Barreiro E, de la Puente B,Minguella J, et al. Oxidative stress and respiratory muscle dysfunction in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2005, 171: 1116 -1124.
20. Tsantes A, Bonovas S, Tassiopoulos S, et al. A comparative study of the role of erythropoietin in the pathogenesis of deficient erythropoiesis in idiopathic pulmonary fibrosis as opposed to chronic obstructive pulmonary disease. Med Sci Monit, 2005, 11: CR177-CR181.

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