Avaliação da função pulmonar e força muscular respiratória em pacientes idosos portadores de anemia – estudo comparativo entre síndromes mielodisplásticas e anemias não-clonais

• Ano de defesa: 2016
• Autor(a) principal: Okubo, Bruno Memória Rodrigues
• Orientador(a): Magalhães, Silvia Maria Meira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Idoso; Pneumopatias; Anemia; Síndromes Mielodisplásica
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/19352

The ageing process is associated with gradual decline in respiratory system performance. Anemia is highly prevalent among older adults and usually associated with adverse outcomes. Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic malignancies characterized by anemia and other cytopenias. The objective of this study was to evaluate respiratory muscle strength and lung function in elderly patients with anemia and compare data between myelodysplastic syndromes and non-clonal anemias. Participants were individuals aged over 60 years, of which 35 were suffering from anemia secondary to MDS, 33 with non-clonal and 31 healthy elderly anemia. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/ FVC ratio were measured by spirometry. Respiratory muscle strength was evaluated by maximal static respiratory pressures measurement. As a result, the average concentration of Hb concentration was comparable between patients with anemia (p=0.06). Significant differences were detected between patients with anemia and controls for maximum-effort inspiratory mouth pressure (PImax) and also for maximum-effort expiratory mouth pressure (PEmax) (p<0.01 for all analyzes). The MDS group recorded a significantly lower PImax and PEmax percent predicted when compared to non-clonal anemia group (p<0.01 for all analyzes). For FVC and FEV1, a significant difference was found in anemic patients, with even lower values for FVC and FEV1 in MDS group. No significant differences were detected for PImax and PEmax and spirometry parameters when anemic patients were stratified according to the degree of anemia. A negative impact of anemia was demonstrated in respiratory muscle strength and lung function particularly in MDS. High ferritin levels and excess blasts adversely influence the parameters assessed in these patients. The elevated levels of proinflammatory cytokines and the prolonged and aberrant inflammatory response are postulated to play a role in the significant reduction of pulmonary function observed.