Study On The Relationship Of Level Of Serum 1,25(OH)₂D₃ And Pulmonary Function, Body Exercise Tolerance In COPD Patients

OBJECTIVE:Determinate the levels of serum 1,25(OH)2D3, calcium, phosphate, magnesium, take the pulmonary function test,blood gas analysis,determinate 6 minate walking test,investgate the frequency of acute exacerbation in last 2 years. The aim of the investigation is to observe the relationship of body exercise tolerance,the severity of COPD and levels of 1,25(OH)2D3 in COPD patients.METHODS:l:Select 202 patients with COPD in 2009,9 to 2010,7, put these patients into two groups:low serum calcium group(serum calcium<2.15 mmol/L)and normal serum calcium group(serum calcium≥2.15 mmol/L),take fasting blood of cubital vein, determinate the levels of serum calcium, phosphate, take the pulmonary function test,blood gas analysis, investgate the frequency of acute exacerbation in last 3 years, investigate the relationship of the levels of serum calcium and age, the levels of serum phosphate,values of pulmonary function test,blood gas analysis, the frequency of acute exacerbation. Then put these patients into two groups:low frequency of acute exacerbation group(1-2 acute exacerbation in last 3 years) and high frequency of acute exacerbation group(3-4 acute exacerbation in last 3 years),compare the levels of serum calcium,and compare the percent of low serum calcium in two groups.2:(1)Select 45 patients with COPD in 202 patients,then take fasting blood of cubital vein,determinate the levels of serum 1,25(OH)2D3 by ELISA, calcium,phosphate,magnesium, take the pulmonary function test,blood gas analysis,determinate 6 minate walking test, investgate the frequency of acute exacerbation in last 2 years. (2)Select 30 health control patients in Medical Center, determinate the levels of serum 1,25(OH)2D3. (3)Analysis the differences of the levels of serum 1,25(OH)2D3 between the two groups. And investigate the relationship of the levels of 1,25(OH)2D3 and electrolytes,values of pulmonary function test,blood gas analysis, the frequency of acute exacerbation.Results:1. The percent of 117 COPD patients with low serum calcium was 57.92% in 202 patients with COPD.The level of serum calcium in low serum calcium group is(2.03±0.09)mmol/L,which is lower than normal serum calcium group(P<0.01).The frequency of acute exacerbation in low serum calcium group is higher than normal serum calcium group (P<0.05).2. In 117 low serum calcium group patients, The level of scrum calcium in low serum calcium group is negatively correlated with age,pH (P<0.05 completely);and is correlated with the level of phosphorus,BMI, PaCO2, FEV1%(P<0.05 completely). In 85 normal serum calcium group patients, The level of scrum calcium is no correlated with other values.3. In 202 COPD patients, the level of scrum calcium in high frequency of acute exacerbation group((2.09±0.12)mmol/L) is lower than low frequency of acute exacerbation group ((2.16±0.16)mmol/L) (P<0.01).The percent of low serum calcium in high frequency of acute exacerbation group is higher than low frequency of acute exacerbation group(P<0.01).4. Compared with the control group, the levels of serum 1,25(OH)2D3,calcium are lower;BMI is lower (P<0.05).5. In COPD group,the levels of serum 1,25(OH)2D3 is positive correlate with calcium,phosphate,FEV1/FVC,FEV1%, PO2,SaO2,6MWD,is negative correlate with pH, the frequency of acute exacerbation in last 3 years (P<0.05).6. In COPD group,the levels of serum calcium is correlated with phosphate, FEV1/FVC,FEV1%, PaO2,SaO2,6MWD,is negative correlated with pH, the frequency of acute exacerbation in last 3 years(P<0.05).Conclusion:1. The percent of low serum calcium in COPD patients was high.2. In COPD group,the levels of serum 1,25(OH)2D3, calcium is lower than the control group.3. In COPD patients with low calcium, serum calcium has relationship with age, serum phosphate, pulmonary function. In COPD patients, serum 1,25(OH)2D3, serum calcium have relationship with the values of blood gas analysis,pulmonary function,6MWD,suggesting that serum 1,25(OH)2D3, serum calcium can reflect the severity of COPD.4. The levels of serum 1,25(OH)2D3, calcium have relationship with the frequency of acute exacerbation. The percent of low serum calcium in COPD patients with high frequency of acute exacerbation was high.COPD patients should add VitD timely, to enhance the immunity, reduce the frequency of acute exacerbation.