Nephrology Department, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
BMC Pulm Med. 2014 Feb 24;14:24. doi: 10.1186/1471-2466-14-24.
Little is known about iron deficiency (ID) and anemia in Chronic Obstructive Pulmonary Disease (COPD). The purposes of this study were: (i) To study the prevalence and treatment of anemia and ID in patients hospitalized with an exacerbation of COPD. (ii) to study the hematological responses and degree of dyspnea before and after correction of anemia with subcutaneous Erythropoiesis Stimulating Agents (ESAs) and intravenous (IV) iron therapy, in ambulatory anemic patients with both COPD and chronic kidney disease.
(i) We examined the hospital records of all patients with an acute exacerbation of COPD (AECOPD) to assess the investigation, prevalence, and treatment of anemia and ID. (ii) We treated 12 anemic COPD outpatients with the combination of ESAs and IV-iron, given once weekly for 5 weeks. One week later we measured the hematological response and the severity of dyspnea by Visual Analogue Scale (VAS).
(i) Anemia and iron deficiency in hospitalized COPD patients: Of 107 consecutive patients hospitalized with an AECOPD, 47 (43.9%) were found to be anemic on admission. Two (3.3%) of the 60 non-anemic patients and 18 (38.3%) of the 47 anemic patients had serum iron, percent transferrin saturation (%Tsat) and serum ferritin measured. All 18 (100%) anemic patients had ID, yet none had oral or IV iron subscribed before or during hospitalization, or at discharge. (ii) Intervention outpatient study: ID was found in 11 (91.7%) of the 12 anemic ambulatory patients. Hemoglobin (Hb), Hematocrit (Hct) and the VAS scale scores increased significantly with the ESAs and IV-iron treatment. There was a highly significant correlation between the ∆Hb and ∆VAS; rs = 0.71 p = 0.009 and between the ∆Hct and ∆VAS; rs = 0.8 p = 0.0014.
ID is common in COPD patients but is rarely looked for or treated. Yet correction of the ID in COPD patients with ESAs and IV iron can improve the anemia, the ID, and may improve the dyspnea.
慢性阻塞性肺疾病（COPD）患者的缺铁（ID）和贫血知之甚少。本研究的目的是：（i）研究 COPD 加重住院患者的贫血和 ID 的患病率和治疗情况。（ii）研究接受皮下红细胞生成刺激剂（ESA）和静脉内（IV）铁治疗的合并 COPD 和慢性肾脏病的贫血门诊患者的血液学反应和呼吸困难程度，在纠正贫血前后。
（i）我们检查了所有急性加重期 COPD（AECOPD）患者的住院记录，以评估贫血和 ID 的检查、患病率和治疗情况。（ii）我们用 ESA 和 IV-铁联合治疗 12 名贫血性 COPD 门诊患者，每周一次，共 5 周。一周后，我们通过视觉模拟量表（VAS）测量血液学反应和呼吸困难严重程度。
（i）住院 COPD 患者的贫血和缺铁：在 107 例连续住院治疗 AECOPD 的患者中，有 47 例（43.9%）入院时贫血。在 60 例非贫血患者中，有 2 例（3.3%）和 47 例贫血患者中有血清铁、转铁蛋白饱和度（%Tsat）和血清铁蛋白测定。所有 18 例（100%）贫血患者均存在 ID，但在住院前、住院期间或出院时均未开具口服或 IV 铁剂。（ii）干预门诊研究：在 12 例贫血门诊患者中发现 11 例（91.7%）存在 ID。血红蛋白（Hb）、血细胞比容（Hct）和 VAS 评分随着 ESA 和 IV-铁治疗显著增加。ESA 和 IV 铁治疗后 Hb 和 VAS 评分的变化呈高度显著相关；rs=0.71，p=0.009 和 Hct 和 VAS 评分的变化呈显著相关；rs=0.8，p=0.0014。
ID 在 COPD 患者中很常见，但很少被发现或治疗。然而，用 ESA 和 IV 铁纠正 COPD 患者的 ID 可以改善贫血、ID，并可能改善呼吸困难。
