Clinical Features Of Hemoglobin In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To investigate the clinical characteristics of hemoglobin（Hb）changes in patients of acute exacerbation of chronic obstructive pulmonary disease（AECOPD）and its potential correlation with acute exacerbation,the Hb of AECOPD patients were collected and analyzed,the clinical characteristics of patients with AECOPD in different Hb levels were compared.Methods:A total of 197 AECOPD patients meeting the study criteria admitted to our hospital from January 1st,2018 to December 31st,2018 were included for this retrospective analysis.The basic information of patients such as age,gender,smoking status,the first blood gas analysis,the first blood routine test,the first lung function result,C-reactive protein（CRP）and procalcitonin（PCT）were well recorded.The distribution of Hb was analyzed.The Hb level and the anemia rate in patients with different lung function which classified by GOLD classification criteria were compared.All correlation analysis between the level of Hb and FEV₁%pred of patients with AECOPD was conducted.With the median Hb level of 129g/L as the boundary,patients with AECOPD were divided into two groups（Hb<129g/L and Hb≥129g/L）according to the size of Hb concentration.The general information,the clinical characteristics,the FEV₁%pred level and the proportion of GOLD3 and GOLD4 level lung function patients of those two groups were compared.Results:1.Of the 197 patients with AECOPD,49 of them were anemia,with a rate of 24.87%;2 of them（1.02%）were hyperhemoglobinemia.Among all anemia patients,the proportion of mild anemia was 91.84%and the normocytic anemia counted for 77.55%among all types of anemia.2.The Hb levels in patients with AECOPD was positively correlated with fev1%pred（r=0.331,P<0.001）.3.When compared with AECOPD patients with Hb level≥129g/L,the patients with Hb<129g/L were older（P<0.001）,the proportion of men was lower（P=0.004）,arterial blood carbon dioxide pressure was higher（P=0.024）,the neutrophil ratio（P=0.011）,CRP（P=0.030）and the positive rate of PCT（P=0.017）were higher.However,the patients were not statistically significant in terms of smoking status,oxygenation index and white blood cell count.4.The Chronic obstructive pulmonary disease（COPD）patients with Hb<129g/L in the acute exacerbation period had lower mean FEV₁%pred and a higher proportion of patients with GOLD3 and GOLD4 lung function than those of patients with Hb≥129g/L.Conclusions:1.The anemia rate of patients with AECOPD is higher than that of patients with high Hb,and the main type of anemia is mainly mild normocytic anemia.2.Senior age,female,severe inflammatory response and low FEV₁%pred are risk factors for decreased Hb in patients with AECOPD.3.The decreased Hb level may be a risk factor for recurrent acute exacerbation in AECOPD patients.