Oh Yeon-Mok, Park Joo Hun, Kim Eun-Kyung, Hwang Sung Chul, Kim Hyun Ji, Kang Dae Ryong, Yoo Kwang Ha, Lee Ji-Hyun, Kim Tae-Hyung, Lim Seong Yong, Rhee Chin Kook, Yoon Hyoung Kyu, Lee Sang Yeub, Lee Sang-Do
Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.
J Thorac Dis. 2017 Dec;9(12):5008-5016. doi: 10.21037/jtd.2017.10.140.
Anemia is a major co-morbidity in chronic obstructive pulmonary disease (COPD). However, the mechanism of development for anemia and the impact of anemia on the prognosis of COPD remain poorly understood. Therefore, this study attempted to evaluate the prognostic role of anemia on the clinical course of COPD and investigate the factors linked with the serum hemoglobin level in COPD.
We analyzed 407 COPD patients enrolled in the Korean obstructive lung disease (KOLD) cohort at 16 hospitals in Korea recruited over 9 years. Multivariate Cox regression analysis was performed to find independent predictors of survival and multivariate logistic regression analyses were done to find independent factors.
Anemic COPD were older with lower body mass index (BMI) (P<0.001), lower serum cholesterol level (P=0.001), lower serum albumin level (P<0.001), and shorter 6-minute walking distance (P=0.046) compared to non-anemic COPD. A multivariate Cox regression analysis revealed that age (P=0.002), BMI (P=0.001), post-bronchodilator forced expiratory volume in 1 second (FEV) (P=0.007), 6-minute walk distance (P=0.008), anemia (P=0.025) were significant predictors for all-cause mortality. In multivariate regression analysis, older age (P<0.001), female gender (P=0.001), lower BMI (P=0.016), and lower serum albumin level (P<0.001) were independent factors associated with lower serum hemoglobin level.
Our data showed that anemia was an independent risk factor for mortality in COPD, and aging, lower serum albumin level, and lower BMI were independent factors associated with lower serum hemoglobin level.
贫血是慢性阻塞性肺疾病（COPD）的一种主要合并症。然而，贫血的发生机制以及贫血对COPD预后的影响仍知之甚少。因此，本研究试图评估贫血对COPD临床病程的预后作用，并探讨与COPD患者血清血红蛋白水平相关的因素。
我们分析了韩国16家医院在9年期间招募的407例参与韩国阻塞性肺疾病（KOLD）队列研究的COPD患者。进行多变量Cox回归分析以找出生存的独立预测因素，并进行多变量逻辑回归分析以找出独立因素。
与非贫血的COPD患者相比，贫血的COPD患者年龄更大，体重指数（BMI）更低（P<0.001），血清胆固醇水平更低（P=0.001），血清白蛋白水平更低（P<0.001），6分钟步行距离更短（P=0.046）。多变量Cox回归分析显示，年龄（P=0.002）、BMI（P=0.001）、支气管扩张剂后1秒用力呼气量（FEV）（P=0.007）、6分钟步行距离（P=0.008）、贫血（P=0.025）是全因死亡率的显著预测因素。在多变量回归分析中，年龄较大（P<0.001）、女性（P=0.001）、BMI较低（P=0.016）和血清白蛋白水平较低（P<0.001）是与血清血红蛋白水平较低相关的独立因素。
我们的数据表明，贫血是COPD患者死亡的独立危险因素，而衰老、血清白蛋白水平较低和BMI较低是与血清血红蛋白水平较低相关的独立因素。
