ผลกระทบที่เกิดกับร่างกายทั้งระบบและภาวะโลหิตจางในโรคปอดอุดกั้นเรื้อรัง
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บทคัดย่อ
โรคปอดอุดกั้นเรื้อรังเป็นโรคที่มีการจำกัดของทางเดินหายใจและส่งผลกระทบต่อการทำหน้าที่ของปอด โรคปอดอุดกั้นเรื้อรังส่งผลกระทบต่อการทำหน้าที่ของทุกระบบในร่างกายหรือที่เรียกว่า systemic effect ภาวะดังกล่าวส่งผลให้ผู้ป่วยโรคปอดอุดกั้นเรื้อรังมีภาวะน้ำหนักลด ภาวะความผิดปกติทางโภชนาการ ผลกระทบทางระบบหายใจและไหลเวียนโลหิต ผลกระทบทางระบบประสาท และผลกระทบต่อระบบโครงร่างและกล้ามเนื้อ ความชุกของภาวะโลหิตจางในผู้ป่วยโรคปอดอุดกั้นเรื้อรังมีเพิ่มมากขึ้นเหมือนกับผู้ป่วย โรคหัวใจ โรคมะเร็งและโรคไต นอกจากนี้ภาวะโลหิตจางในผู้ป่วยโรคปอดอุดกั้นเรื้อรังส่งผลทำให้ความสามารถในการออกกำลังกายและคุณภาพชีวิตลดลง กลไกที่ทำให้เกิด systemic effect และภาวะโลหิตจางในผู้ป่วยยังไม่สามารถสรุปได้แน่ชัด แต่จะพบว่าภาวะดังกล่าวมีความสัมพันธ์กับการทำกิจวัตรประจำวันที่ลดลง การอักเสบในระบบร่างกาย ภาวะพร่องออกซิเจนในเนื้อเยื่อ และสภาวะความเครียดออกซิเดชัน (oxidative stress) ดังนั้นการประเมินและการรักษาในผู้ป่วยโรคปอดอุดกั้นเรื้อรังที่ช่วยทำให้ภาวะ systemic effect และภาวะโลหิตจางดีขึ้นน่าจะเป็นแนวทางที่ช่วยทำให้การรักษาในผู้ป่วยโรคปอดอุดกั้นเรื้อรังที่มีประสิทธิภาพอีกวิธีหนึ่ง
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References
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30. Kalra PR, Bolger AP, Francis DP, et al. Effect of anemia on exercise tolerance in chronic heart failure in men. Am J Cardio 2003; 91: 888-91.
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32. Tassiopoulos ST, Kontos A, Konstantopoulos K, et al. Erythropoietic response to hypoxiamia in diffuse idiopathic pulmonary fibrosis, as pooosed to chronic obstructive pulmonary disease. Respir Med 2001; 95: 471-5.
33. Schonhofer B, Wenzel M, Geibel M, Kohler D. Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease. Crit Care Med 1998; 26: 1824-38.
34. Scoppetta C, Grassi F. Erythropoietin: a new tool for muscle disorders? Med Hypotheses 2004; 63: 73-5.
2. Regional COPD work group. COPD prevalence in 12 Asia–Pacific countries and regions: Projections based on the COPD prevalence estimation model. Respirology 2003; 8: 192–8.
3. Maranetra KN, Chuaychoo B, Dejsomritrutai W, et.al. The prevalence and incidence of COPD among urban older persons of Bangkok Metropolis. J Med Assoc Thai. 2002; 85(11): 1147-55.
4. Singh S. Chronic obstructive pulmonary disease. Cur Anaes & Cri Care 2003; 14: 74-80.
5. Wouters E, Creutzberg E. Systemic effects in COPD. Chest 2002; 121: 127-30.
6. Agusti AGN, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 347-60.
7. Barnes PJ, Chowdhury B, Kharitonov SA, et al. Pulmonary biomarkers in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 174(1):6-14.
8. Casaburi R. Skeletal muscle function in COPD. Chest 2000; 117: 267S-71S
9. Karadag F, Karul AB, Cildag O, Altun C, Gurgey O. Determinants of BMI in patients with COPD. Respirology 2004; 9: 70-5.
10. Montes de Oca M, Torres SH, Gonzalez Y, et al. Peripheral muscle composition and health status in patients with COPD. Respir Med 2006; 100(10): 1800-6.
11. Sauleda J, Gea J, Orozco-Levi M. Structure and function relationships of the respiratory muscles. Eur Respir J 1998;11:906-11
12. Curkendall SM, DeLuise C, Jones JK, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Ann Epidemiol 2006; 16: 63-70.
13. Huiart L, Ernst P, Suissa S. Cardiovascular morbidity and mortality in COPD. Chest 2005; 28: 2640-6.
14. Stewart AG, Waterhouse JC, Howard P. Cardiovascular autonomic nerve function in patients with hypoxaemic COPD. Eur Respir J 1991; 4: 1207-14.
15. Stein PK, Nelson P, Rottman JN, et al. Heart rate variability reflects severity of COPD in PiZ alpha1- antitrypsin deficiency. Chest 1998; 113: 327-33.
16. Yildiz P, Tükek T, Akkaya V, et al. Ventricular arrhythmias in patients With COPD are associated with QT dispersion. Chest 2002; 122: 2055-61.
17. Ionescu AA, Schoon E. Osteoporosis in chronic obstructive pulmonary disease. Eur Respir J 2003; 22: 64s–75s
18. Jorgensen NR, Schwarz P, Holme I, Henriksen BM, Petersen LJ, Backer V. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease—A cross sectional study. Respir Med 2007; 101(1): 177-85.
19. John M, Lange A, Hoernig S, Witt C, Anker SD. Prevalence of anemia in chronic obstructive pulmonary disease: Comparison to other chronic diseases. Inter J Cardio 2006; 111: 365-70
20. Gabrilove J. Anemia and the elderly: clinical considerations. Best Prac & Research Clin Haem 2005; 18: 417-22.
21. Penninx BW, Pahor M, Woodman RC, Guralnik JM. Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 2006; 61(5): 474-9.
22. Issaragrisil S, Kaufman DW, Anderson T, et.al. The epidemiology of apastic anemia in Thailand. Blood 2006; 107: 1299-307.
23. World Health Organization. Nutritional anemia: report of a WHO Scientific Group. Geneva: Switzerland 1968.
24. Mayhew M. Anemia of chronic disease in the elderly. J Nurse Pract 2006: 261-7.
25. Erschler WB, Chen K, Reyee EB, Dubois R. Economic burden of patients with anemia in selected disease. Value Health 2005; 8(6): 629-38.
26. John M, Hoernig S, Doehner W, Okonko DD, Witt C, Anker SD. Anemia and Inflammation in COPD. Chest 2005; 127: 825-9.
27. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 1005-12.
28. Similowski T, Agusti A, MacNee W, Schonhofer B. The potential impact of anemia of chronic disease in COPD. Eur Respir J 2006; 27: 390-6.
29. Chambellan A, Challeux E, Similowski T. Prognostic value of the hematocrit in patients with severe COPD receiving long term oxygen therapy. Chest 2005; 128: 1201-8.
30. Kalra PR, Bolger AP, Francis DP, et al. Effect of anemia on exercise tolerance in chronic heart failure in men. Am J Cardio 2003; 91: 888-91.
31. Mancini DM, Katz SD, Lang CC, LaManca J, Hudaihed A, Androne AS. Effect of erythropoietin on exercise capacity in patients with moderate to severe chronic heart failure. Circulation 2003; 107: 294-9.
32. Tassiopoulos ST, Kontos A, Konstantopoulos K, et al. Erythropoietic response to hypoxiamia in diffuse idiopathic pulmonary fibrosis, as pooosed to chronic obstructive pulmonary disease. Respir Med 2001; 95: 471-5.
33. Schonhofer B, Wenzel M, Geibel M, Kohler D. Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease. Crit Care Med 1998; 26: 1824-38.
34. Scoppetta C, Grassi F. Erythropoietin: a new tool for muscle disorders? Med Hypotheses 2004; 63: 73-5.