Role Of Serum Elements Copper, Zinc In The Oxidative Stress And Inflammation Reaction Of Chronic Obstructive Pulmonary Disease

Objectives: By detecting serum trace elements copper, zinc levels and oxidative stressand inflammation indicators malond-ialdehyde (MDA) and hypersensitive c-reactiveprotein (hs-CRP) level in patients of chronic obstructive pulmonary disease (COPD)with acute aggravating period before and after treatment and explore the serum traceelements copper, zinc in the role of oxidative stress and inflammation reactionmechanism of COPD.The research object and methods：97patients with chronic obstructive pulmonarydisease with acute aggravating period (men/women86/11) hospitalized in thedepartment of Respiratory in the second hospital of Dalian Medical University duringOctober2012to December2013. The average age of patients was69.34±9.47.50healtypeople for physical examination during the same time in the same hosipital werechoosed as control group (men/women43/7).The average age of control group was68.44±7.19. According to GOLD2011COPD assessment criteria,COPD patients weresubgrouped into four groups:group A,patients who were low risk and less symptoms(n=21); group B,patients who were low risk and symptom heavier (n=25); groupC,patients who were less risky and symptoms (n=24); group D,patients who werehigh-risk and symptom heavier (n=27).Patients in COPD group were treatmented withanti-inflammatory, smooth wheezing, expectorant for8to12days. Serum levels of traceelements copper, zinc in COPD group and control group before and after the treatmentwas detected in and compared with MDA, and hs-CRP level.To investigate the relevant of elements copper, zinc, MDA, and hs-CRP, and the relationship with elements copper,zinc and the occurrence and severity of COPD.Results:（1）Difference of serum copper、serum zinc、MDA、hs-CRP levelbetween different COPD groups and the control group showed that serum copperMDA、hs-CRP level in different COPD groups before treatment was significantly higherthan control group, the difference was statistically significant (P＜0.05). Serum zinclevel in COPD groups before treatment was lower than control group, the differencewas statistically significant (P＜0.05);(2) Difference of serum copper、serum zinc、MDA、hs-CRP level between different groups of COPD showed that serum copper、serum zinc had significant differences using analysis of variance (P＜0.05),The leastsignificant difference analysis showed that there was no siginificant differences betweengroup A and group B（P＞0.05）,but group A, group C and group D,group B,group Cand group D,group C and group D had siginificant differences (P＜0.05). MDA andhs-CRP level between different groups of COPD had siginificant difference（sP＜0．05）.The least significant difference analysis showed that there was siginificant differences ingroup A, group B,group C and group D,group B, group C and group D,group C andgroup D (P＜0.05).(3)Difference of serum copper,serum zinc,MDA,hs-CRP levelbetween the before and after treatment in four COPD groups showed that serumcopper,MDA and hs-CRP level after treatment were lower than before treatment inCOPD group, And the difference was statistically significant (P＜0.05).Serum zinclevel after treatment was higher than after treatment four COPD groups,but nosignificant difference was found in serum zinc(P＞0.05).(4) The correlation of serumcopper,serum zinc level, MDA and hs-CRP level in four COPD groups showed thatthe serum copper level, MDA and hs-CRP level were significantly positive correlationusing Pearson correlation analysis (P <0.05).Serum zinc、MDA and hs-CRP level withserum copper level had negative correlation. There was significantly positive correlationin MDA and hs-CRP in four COPD groups(P＜0.05); There was significantly negativecorrelation in serum copper and serum zinc in four COPD groups (P＜0.05).Conclusions:(1)Serum copper in COPD groups was higher than control group,while serum zinc in COPD groups was lower than control group, with oxidative stress andinflammation in it.(2)With the exacerbation of COPD,level of serum copper wasapparently higher,while level of serum zinc was apparently lower and the balance ofoxidative stress and inflammation reaction were heavier.(3) The levels of oxidativestress and inflammation of COPD patients after the treatment were better than before,the serum copper was lower than before, the serum zinc did not change significantly.(3)The level of serum copper had significantly positively relation with MDA,hs–CRP， serum zinc had significantly negative relation with MDA, hs–CRP，soserum copper and serum zinc might play an important role in oxidative stress andinflammation of COPD.Serum copper might play a promote the role of oxidative stressand inflammation, serum zinc might play the function of inhibiting oxidative stressand inflammation.