Changes in hepatic blood flow in patients with comorbidity of chronic obstructive pulmonary disease and vitamin B12 deficiency anemia
https://doi.org/10.36604/1998-5029-2023-88-35-40
Abstract
Introduction. Altered hemodynamics in the liver is associated with an obligate manifestation of hypoxic stress that affects the functional status of patients with chronic obstructive pulmonary disease (COPD), which is important to consider in patients with comorbid pathology.
Aim. The study of the characteristics of hepatic blood flow in patients with COPD with vitamin B12 deficiency anemia.
Materials and methods. 58 patients with COPD were examined, mean age was 50.1±3.5 years, smoking history was 21.6±2.1 pack/years. The patients were divided into two groups: group 1 included 30 COPD patients without anemia, group 2 included 28 patients with concomitant vitamin B12 deficiency anemia.
Results. It was found that in the 2nd group of patients there was a decrease by 13.8% in the ratio of the linear velocity of the portal flow and the diameter of the portal vein (Wilcoxon T-test, p=0.01), which is associated with “stagnant” phenomena of blood flow in the liver. At the same time, the functional parameters of blood flow in the hepatic pool of the bloodstream in patients of group 1 practically did not differ from those of healthy individuals (Mann-Whitney U Test, p=0.1).
Conclusion. The presence of vitamin B12 deficiency anemia in patients with COPD initiates adverse changes in liver blood flow, which should be taken into account when stratifying the risk of this category of patients.
About the Authors
A. N. Zhekotov
Pacific State Medical University
Russian Federation
Russian Federation
Andrey N. Zhekotov, Assistant of the Department of Disaster Medicine and Life Safety
2 Ostryakova Ave., Vladivostok, 690002,
V. N. Kotelnikov
Pacific State Medical University;
Far Eastern Branch of Research and Testing Institute of Military Medicine
Russian Federation
Russian Federation
Vladimir N. Kotelnikov, MD, PhD, DSc (Med.), Professor, Head of the Department of Disaster Medicine and Life Safety; Head
2 Ostryakova Ave., Vladivostok, 690002;
100D Borisenko Str., Vladivostok, 690080
B. I. Geltser
Far Eastern Federal University, School of Medicine
Russian Federation
Russian Federation
Boris I. Geltser, MD, PhD, DSc (Med.), Professor, Corresponding member of RAS, Deputy Scientific Director of the School of Medicine
10 Ajax Bay, FEFU Campus, Building 25, Russky Island, Vladivostok, 690920
References
1. Geltser B.I., Kurpatov I.G., Kotelnikov V.N., Zayats Y.V. [Chronic obstructive pulmonary disease and cerebrovascular diseases: functional and clinical aspect of comorbidity]. Terapevticheskii arkhiv 2018; 90(3):81–88 (in Russian). https://doi.org/10.26442/terarkh201890381-88
2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Update 2017. Available at: https://goldcopd.org
3. [Federal clinical guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease]. Moscow: Russian Respiratory Society; 2021 (in Russian). Available at: https://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/
4. Geltser B.I., Kotelnikov V.N., Kozhanov A.G. [Respiratory and muscular dysfunction of the respiratory muscles and chronic obstructive pulmonary disease: pathophysiological relationships and clinical significance]. Pacific Medical Journal 2022; (1):17–25 (in Russian). https://doi.org/10.34215/1609-1175-2022-1-17-25
5. Avdeev S.N. [Pathologic physiology of exacerbations of chronic obstructive pulmonary disease]. Vestnik anesteziologii i reanimatologii = Messenger of Anesthesiology and Resuscitation 2019; 16(2):75–82 (in Russian). https://doi.org/10.21292/2078-5658-2019-16-2-75-82
6. Zhusina Yu.G., Budnevskiy A.V., Fes’kova A.A., Ovsyannikov E.S. [About relationship between chronic obstructive pulmonary disease and anemia]. Pulmonologiya 2018; 28(6):730–735 (in Russian). https://doi.org/10.18093/0869-0189-2018-28-6-730-735
7. Gao X., Lindqvist A., Sandberg M., Groop L., Wierup N., Jansson L. Effects of GIP on regional blood flow during normoglycemia and hyperglycemia in anesthetized rats. Physiol. Rep. 2018; 6(8):e13685. https://doi.org/10.14814/phy2.13685
8. Froese D.S., Fowler B., Baumgartner M.R. Vitamin B12, folate, and the methionine remethylation cycle-biochemistry, pathways, and regulation. J. Inherit. Metab. Dis. 2019; 42(4):673–685. https://doi.org/10.1002/jimd.12009
9. [Vitamin B12 deficiency anemia. Clinical Guidelines]. Moscow; 2021 (in Russian). Available at: https://cr.minzdrav.gov.ru/schema/536_2
10. Beresten N.F., Sandrikov V.А., Fedorova S.I., editors. [Functional Diagnostics. National Guidelines]. Moscow: GEOTAR-Media; 2019 (in Russian). ISBN: 978-5-9704-4242-5.
Review
For citations:
Zhekotov A.N., Kotelnikov V.N., Geltser B.I. Changes in hepatic blood flow in patients with comorbidity of chronic obstructive pulmonary disease and vitamin B12 deficiency anemia. Bulletin Physiology and Pathology of Respiration. 2023;(88):35-40. (In Russ.) https://doi.org/10.36604/1998-5029-2023-88-35-40
Views:
145
Email this article 