Prevalence And Related Factors Of Anemia In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

COPD is a group of chronic lung disease characterized by airflow limited and airflow limited is not fully reversible, with high morbidity and high mortality. Acute exacerbation of chronic obstructive pulmonary disease(AECOPD) refers to the COPD patients with an acute onset,which is that the fatality rate is high, the performance for respiratory symptoms worsen sharply, the lung function declines, and even respiratory failure life-threatening. The traditional concept suggests that due to chronic hypoxia, the patients with COPD often appear secondary erythrocytosis, but in recent years, studies have found that the prevalence of anemia in patients with COPD is high and anemia has a negative impact on COPD patients,effecting the quality of life, the use of medical resources, the health care costs and prognosis. Therefore, chronic obstructive pulmonary disease complicated with anemia should be paid extensive attention and should be solved in a timely and effective manner in clinical.Objective:To investigate the prevalence and clinical features of AECOPD combined with anemia in our hospital, to explore the possible related factors, and to improve the understanding of AECOPD combined with anemia.Methods:258 cases with clear diagnosis of acute exacerbation of chronic obstructive pulmonary disease were collected from January 2014 toOctober 2015 in the ward of Department of Respiratory Medicine in the First Hospital of Jilin University. The patients were divided into anemia group and non anemia group according to the hemoglobin level, with the records of each patient demographic data(gender, age, height, weight,smoking status, admission temperature, course of disease, according to the height and weight index calculation), white blood cell count(WBC),neutrophil count, neutrophil percentage, red blood cell count(RBC),hemoglobin(Hb), hematocrit(HCT), mean red blood cell volume(MCV),mean red blood cell hemoglobin corpuscular(MCHC), C reactive protein(CRP), erythropoietin(EPO), erythrocyte sedimentation rate(ESR),serum total protein, serum albumin(ALB), pulmonary function, arterial(FEV1% estimated value), arterial blood gas analysis(PO2,PCO2),antibiotics application time, hospitalization days, hospitalization expenses,compare and analyze the related factors between the two groups. The results were statistical processed by SPSS19.0 statistical software, and P<0.05 for the difference was statistically significant.Results:1. The prevalence of anemia in patients with acute exacerbation of COPD(AECOPD) in our hospital was 19.77%. The prevalence of patients with increased hemoglobin was 3.88%, and the prevalence of anemia in patients with AECOPD was significantly higher than that in the patients with increased hemoglobin.2. Compared with the non anemia group of AECOPD, the AECOPD combined anemia group was older(P<0.05), its body mass index(BMI)was lower(P<0.05), and its Hb was negatively correlated with age(r=-0.259, P=0.001). Compared with non anemia group, the proportion of fever patients in the anemia group was greater than that in the non anemia group(P<0.05). In the aspects of gender, course of disease,smoking index, lung function(FEV1% expected value) and arterial blood gas analysis(P02, PCO2), there were no significant difference(P>0.05)and the difference did not have statistical significance in the two groups.3. Compared with non anemia group of AECOPD, white blood cell count, neutrophil count, neutrophil percentage, CRP, ESR and EPO were significantly increased more(P<0.05) in AECOPD patients with anemia group, and the differences were statistically significant. The results of HCT, HCV, MCHC, serum albumin(ALB) in the anemia group were significantly lower(P<0.05), and the differences were statistically significant. There was no statistically significant difference in serum total protein between the two groups(P>0.05). Hemoglobin was negatively correlated with CRP, ESR and EPO(R values and P values were respectively: r=-0.447, P=0.000; r=-0.345,P=0.000; r=-0.420,P=0.000),but was positively correlated with serum albumin and body mass index(BMI)(R values and P values were respectively: r=0.272,P=0.006;r=0.249,P=0.005).4. Compared with the non anemia group of AECOPD, the antibiotics application time, hospital days, and hospital costs of AECOPD combined anemia group were generally higher than the non anemia group, the differences were statistically significant(P<0.05).Conclusion:1. The prevalence rate of AECOPD combined with anemia is high,and is significantly higher than that of the increased hemoglobin. The anemia of AECOPD is mild to moderate anemia, normal cell low pigment anemia;2. AECOPD combined with anemia is related to inflammatory reaction and erythropoietin resistance. Aging and malnutrition are involved in the occurrence of anemia;3. The utilization of medical resources and medical costs are more on AECOPD combined with anemia.