| Abstract (croatian) | Uvod: Cilj istraživanja bio je odrediti vrijednosti hematoloških biljega anemije i koncentracije C-reaktivnog proteina (CRP) kod bolesnika oboljelih od stabilne kronične opstrukcijske plućne bolesti (KOPB), kako bi se utvrdila prisutnost anemije, stupanj sistemske upale i korelacija između analita.
Materijali i metode: U ispitivanje je bilo uključeno 150 bolesnika s KOPB (forsirani ekspiracijski volumen u prvoj sekundi (engl. forced expiratory volumein 1 second (FEV1) = 48 ± 21%) i 51 kontrolni ispitanik (FEV1 = 106 ± 15%). Prema smjernicama Globalne inicijative za kroničnu opstrukcijsku plućnu bolest (engl. Global Initiative for Chronic Obstructive Lung Disease, GOLD) bolesnici su podijeljeni u četiri podskupine, a prema kriterijima SZO za anemiju u dvije skupine: ispitanici s anemijom i bez nje. Koncentracija CRP u serumu određena je imunoturbidimetrijskom metodom, a koncentracija hematoloških biljega protočnom citometrijom.
Rezultati: Nije nađena statistički značajna razlika u broju eritrocita, koncentraciji hemoglobina i vrijednostima hematokrita između skupine svih bolesnika s KOPB i kontrolne skupine, kao ni između podskupina GOLD i kontrolne skupine. Anemija je bila prisutna kod 24% bolesnika. Koncentracija CRP bila je statistički značajno viša kod skupine svih bolesnika s KOPB (P < 0,001), svih podskupina GOLD (I. P < 0,001; IIA., IIB., III. P < 0,001) i podskupina s anemijom i bez nje (P < 0,001) u usporedbi s kontrolnom skupinom. Specifičnost i osjetljivost CRP određena je ROC analizom i pokazala je dobru dijagnostičku točnost koncentracije CRP kod bolesnika s KOPB. Koeficijent korelacije između koncentracije CRP i koncentracije hemoglobina odnosno vrijednosti hematokrita otkrio je dobru negativnu korelaciju (CRP i hemoglobin: r = -0,60, P < 0,001; CRP i hematokrit: r = -0,59, P < 0,001) samo u podskupini GOLD III.
Zaključak: Koncentracija CRP, biljega sistemske upale, bila je statistički značajno viša kod bolesnika s KOPB i kod svih podskupina GOLD u usporedbi s kontrolnom skupinom. Zabilježena je dobra negativna korelacija između vrijednosti hematokrita i koncentracije hemoglobina te uznapredovale upale (koncentracija CRP) kod podskupine GOLD III. Postotak bolesnika s anemijom bio je u skladu s podacima iz literature. |
| Abstract (english) | Background: The aim of the study was to determine the values of hematological markers of anemia and of C-reactive protein (CRP) in patients with stable chronic obstructive pulmonary disease (COPD) in order to define the presence of anemia, degree of systemic inflammation and correlations between the analytes.
Material and methods: The study included 150 COPD patients (FEV1 = 48 ± 21%) and 51 control subjects (FEV1 = 106 ± 15%). Pursuant to GOLD guidelines, the patients were divided into four subgroups and according to WHO criteria for anemia into two subgroups: subjects with and those without anemia. Serum CRP concentration was determined by immunoturbidimetric method and hematological markers were determined by flow cytometry.
Results: No significant differences were found in the values of erythrocytes, hemoglobin and hematocrit either between the group of all COPD patients and control subjects or between GOLD subgroups and control subjects. Anemia was present in 24% of COPD patients. CRP concentration was significantly higher in the group of all COPD patients, in all GOLD subgroups (I, IIA, IIB and III) and in subgroups with and without anemia as compared to control subjects (P < 0.001 all). CRP specificity and sensitivity were determined by ROC analysis and showed good diagnostic accuracy for CRP in COPD patients. Correlation coefficient between CRP and hemoglobin and hematocrit values revealed a good negative correlation (r = -0.60 and r = -0.59, respectively; P < 0.001 both) only in GOLD subgroup III.
Conclusion: CRP concentration, a marker of systemic inflammation, was signiVcantly higher in COPD patients and in all GOLD subgroups as compared to the control group. Good negative correlation was recorded between hematocrit and hemoglobin values and advanced inflammation (CRP concentration) in GOLD subgroup III. The rate of anemia was in agreement with literature data. |
