Ferrari Marcello, Manea Lorenzo, Anton Kamel, Bruzzone Paola, Meneghello Mara, Zamboni Francesco, Purgato Luigi, Cazzoletti Lucia, Ferrari Pietro, Testi Renato
Unit of Respiratory Diseases, Department of Medicine, University of Verona, Verona, Italy.
School of Sports Medicine, University of Padova, Verona, Trieste and Udine, Italy.
BMC Pulm Med. 2015 May 8;15:58. doi: 10.1186/s12890-015-0050-y.
Little is known about the relationship between hemoglobin concentrations, functional status and health related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD). Our aim was to investigate the prevalence of anemia and the association of hemoglobin with shortness of breath, exercise capacity, muscle strength and HRQL, in COPD patients.
A total of 105 COPD patients (77 males, 71.6 ± 9.2 years) were studied. Patients were classified as anemic and non anemic using the WHO criteria. We used the Medical Research Council Dyspnoea scale (MRCs) to measure shortness of breath. Exercise capacity was assessed using the six minute walking distance (6MWD) and the peak of VO2 during the maximal cycle ergometer test (VO2max). We used the Quadriceps and Handgrip strength assessment to determine muscle strength. The Saint George Respiratory Questionnaire was used to investigate HRQL. The physiological/functional characteristics of the two groups were compared. Regression models adjusting for confounders examined the independent association of anemia and of hemoglobin levels with clinical and functional outcomes.
Anemic patients (12.3%) showed a significantly higher MRCs, a lower 6MWD, VO2max, and a worse quality of life. On the contrary, there was no difference in muscle strength between the two groups. In the regression models, hemoglobin was independently associated with reduced exercise capacity and HRQL.
Anemia in COPD was a risk factor for poorer exercise capacity and quality of life, and these outcomes were linearly associated with hemoglobin. Our results should stimulate further research into exploring whether increasing hemoglobin has a beneficial effect on the outcomes in COPD.
关于慢性阻塞性肺疾病（COPD）患者血红蛋白浓度、功能状态与健康相关生活质量（HRQL）之间的关系，目前所知甚少。我们的目的是调查COPD患者贫血的患病率以及血红蛋白与呼吸急促、运动能力、肌肉力量和HRQL之间的关联。
共研究了105例COPD患者（77例男性，年龄71.6±9.2岁）。采用世界卫生组织标准将患者分为贫血组和非贫血组。我们使用医学研究委员会呼吸困难量表（MRCs）来测量呼吸急促程度。通过六分钟步行距离（6MWD）和最大运动心肺功能测试（VO2max）期间的VO2峰值来评估运动能力。我们使用股四头肌和握力评估来确定肌肉力量。采用圣乔治呼吸问卷来调查HRQL。比较两组的生理/功能特征。调整混杂因素的回归模型检验了贫血和血红蛋白水平与临床及功能结局的独立关联。
贫血患者（12.3%）的MRCs显著更高，6MWD、VO2max更低，生活质量更差。相反，两组之间的肌肉力量没有差异。在回归模型中，血红蛋白与运动能力降低和HRQL独立相关。
COPD患者贫血是运动能力和生活质量较差的危险因素，这些结局与血红蛋白呈线性相关。我们的结果应促使进一步研究探索提高血红蛋白是否对COPD患者的结局有有益影响。
