ANEMIA AND FERROKINETIC PARAMETERS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Аннотация

INTRODUCTION factors for the occurrence and progression of Chronic obstructive pulmonary disease (COPD) is COPD. A number of studies have shown that one of the leading causes of morbidity and changes in blood rheology are common in patients mortality in modern society and represents a with COPD and can be considered a definite risk significant economic and social problem that does factor for the progression of COPD. However, the not yet tend to improve [5,8]. It is known that the incidence and prognostic role of changes in the prevalence, morbidity and mortality of COPD are main parameters of peripheral blood have not associated with the prevalence of tobacco smoking been sufficiently studied [1,6]. In this regard, the and air pollution, and therefore varies in different purpose of the study was to study the incidence of countries [3,4]. At the same time, in recent years, anemia and ferrokinetic parameters in patients much attention has been paid to the study of a with chronic obstructive pulmonary disease. number of other exogenous and endogenous risk https://www.theamericanjournals.com/index.php/tajmspr 37 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE09 METHODS when the level of Hb < 120 g/l in women and Hb < 130 g/l in men) serum iron (normal level in men 80 patients with COPD were under observation, 8.1-26.6 µmol/l, in women 5.4-26.0 µmol/l), among whom there were 51 (63.7%) men and 29 ferritin (normal level in men 30-400 ng/ml, in (36.3%) women. Grade 1 COPD severity was women under 50 years of age 15-150 ng/ml, in diagnosed in 25 patients, grade II – in 28 and grade women after 50 years 30-400 ng/ml), transferrin III – in 27 patients. The diagnosis of “Chronic (optimal level 2.0-3.6 g/l). obstructive pulmonary disease” was established based on the criteria set out in the “Global strategy RESULTS AND DISCUSSION for the diagnosis, treatment and prevention of As a result of the studies, anemia was detected in COPD” GOLD program (2003). The control group 17.5% of patients with COPD, and polycythemia in consisted of 20 healthy individuals of the 5%. At the same time, iron deficiency anemia (IDA) appropriate age. The average age of the patients was detected in 10 patients with COPD, iron was 47±1.5 years. A general blood test was concentration was reduced in 8 patients, serum performed according to standard methods. ferritin was below 100 ng/ml in 9 patients, serum Features of ferrokinetics were assessed by transferrin was reduced in 10 COPD patients with hemoglobin concentration (anemia was diagnosed anemia. Some blood parameters of COPD patients with and without anemia. Control COPD without COPD with COPD with Parameters group anemia anemia polycythemia (n (n = 20) (n = 62) (n = 14) = 4) Hemoglobin, g/l 127±5,87 143,31±2,49** 68,87±2,08 157±15,28 Hematocrit, % 38,1±1,7 42,9±1,7* 31,5±1 47,2±4,4 Red blood cells/pl 4,3±0,2 4,7±0,2 4±0,1 5,8±1 Serum iron, µmol/l 14,3±0,6 13,4±0,7 13,4±0,5 14,5±1,4 Ferritin, ng/ml 184,4±8,4 189,9±7,6 182,7±5,8 187,3±24,3 Transferrin g/l 2,7±0,1 2,2±0,1*** 2,1±0,1 2,6±0,2 CRP (log), mg/dl 0,2±0*** 0,5±0 0,5±0,1 Note: * P<0.05, ** P<0.01,***P<0.001–statistical significance compared to control. differentiated approach is necessary when Thus, every fifth COPD patient examined suffered prescribing iron supplements to these patients, from anemia, although it is traditionally believed depending on the concentrations of iron, ferritin that patients with COPD suffer from polycythemia. and serum transferrin. This confirms the hypothesis about the inhomogeneity of the phenotypic types of COPD According to the results of our study, the level of C- and the need for a differentiated approach in reactive protein in patients with COPD was prognosis and treatment of this cohort of patients significantly higher than in the examined [2]. At the same time, analysis of iron metabolism individuals in the control group. Moreover, this indicators during the study demonstrated that not indicator was significantly higher in COPD patients all patients with COPD in combination with anemia with anemia compared to COPD patients without suffer from iron deficiency. Therefore, a anemia (Table1). https://www.theamericanjournals.com/index.php/tajmspr 38 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE09 The level of erythropoietin in the blood serum of aggravated the course of the disease. A correlation COPD patients with anemia was 2.5 times higher analysis revealed a direct correlation between the than the same indicator in COPD patients without degree of anemia and the severity of bronchial anemia. This may be explained by the resistance of obstruction, as well as an inverse correlation the bone marrow of these patients to between the concentration of C-reactive protein erythropoietin, which is a common finding in and hematocrit in patients with COPD. This may a