Department of Pulmonary Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Int J Clin Pract. 2013 Jun;67(6):558-65. doi: 10.1111/ijcp.12125.
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases, with an increasing rate in morbidity and mortality. In recent years, there has been a greater awareness about the clinical importance of systemic effects and other chronic conditions associated with COPD, as these significantly impact on the course of disease. The most studied extrapulmonary manifestations in COPD include the presence of concomitant cardiovascular disease, skeletal muscle wasting, osteoporosis and lung cancer. Anaemia is a recognised independent marker of mortality in several chronic diseases. Recent studies have shown that anaemia in patients with COPD may be more frequent than expected, with a prevalence ranging from 5% to 33%. Some evidence suggests that systemic inflammation may play an important pathogenic role, but anaemia in COPD is probably multifactorial and may be caused by others factors, such as concealed chronic renal failure, decreased androgenic levels, iron depletion, angiotensin-converting enzyme inhibitor treatment and exacerbations. Low levels of haemoglobin and haematocrit in COPD patients have been associated with poor clinical and functional outcomes as well as with mortality and increased healthcare costs. Despite the potential clinical benefit of successfully treating anaemia in these patients, evidence supporting the importance of its correction on the prognosis of COPD is uncertain.
慢性阻塞性肺疾病（COPD）是最常见的慢性疾病之一，其发病率和死亡率呈上升趋势。近年来，人们越来越意识到 COPD 与全身效应和其他慢性疾病相关的临床重要性，因为这些疾病对疾病进程有重大影响。在 COPD 中研究最多的肺外表现包括并存的心血管疾病、骨骼肌消耗、骨质疏松症和肺癌。贫血是几种慢性疾病中公认的死亡率独立标志物。最近的研究表明，COPD 患者的贫血可能比预期更常见，患病率从 5%到 33%不等。一些证据表明，全身炎症可能起着重要的致病作用，但 COPD 中的贫血可能是多因素的，可能由其他因素引起，如隐匿性慢性肾衰竭、雄激素水平降低、铁耗竭、血管紧张素转换酶抑制剂治疗和加重。COPD 患者的血红蛋白和血细胞比容水平较低与临床和功能结局不良以及死亡率和增加的医疗保健费用有关。尽管成功治疗这些患者的贫血可能具有潜在的临床益处，但支持纠正 COPD 预后重要性的证据尚不确定。
