慢性阻塞性肺疾病并发贫血的机制探讨

To explore the mechanism of COPD complicated anemia

目的从系统炎症的角度探讨阻塞性肺疾病并发贫血的机制。方法选择慢性阻塞性肺疾病急性加重期患者80例,根据血红蛋白水平分成血红蛋白正常组35例,高血红蛋白组30例,贫血组15例,运用ELISA法测血清中IL-6、TNF-α、促红细胞生成素(EPO)、C反应蛋白。比较各组之间的差异。结果高血红蛋白组和贫血组中促红细胞生成素明显高于血红蛋白正常组(P<0.05),IL-6、TNF-α、CRP在三组之间无统计学差异(P>0.05),高血红蛋白组中促红细胞生成素与血红蛋白水平呈正相关(r=0.843,P<0.05),贫血组中IL-6与EPO血红蛋白与EPO呈负相关(r=-0.912,P<0.05)。IL-6、CRP、TNF-α与EPO之间在各组中均无明显的相关性(P>0.05)。结论 COPD并发贫血与促红细胞生成素抵抗有关,但全身炎症反应并不能解释其发生的机制。

Objective To explore the mechanism of chronic obstructive pulmonary disease complicated anemia from the opinion of systemic inflammation. Methods 80 cases of acute exacerbation of chronic obstructive pulmonary disease were selected, which were divided into 3 groups according to the level of hemoglobin. 35 cases were normal hemog/obin group,30 cases were high hemoglobin group, 15 cases were anemia group. IL-6,TNF-α,erythropoietin（EPO） ,C-reactive protein（CRP） were measured in serum through ELISA methods. Results erythropoietin was higher in high hemoglobin group and anemia group than normal hemoglobin group（ P 〈 0.05 ）. IL-6 ,TNF-α, CRP in the three groups was not statistically significant（ P 〉 0.05 ）. erythropoietin was positive relation with hemoglobin in high hemoglobin group（ r = 0. 843 ,P 〈0. 05 ） ,which was negative relation with hemoglobin in anemia group（ r = - 0. 912 ,P 〈 0. 05 ）. IL-6, TNF-α, CRP was not relation with EPO in each group （ P 〉 0.05 ）. Conclusion COPD complicated anemia can be relation with erythropoietin resistance, systemic inflammation response can not explain the exact mechanism.