阿法骨化醇联合碳酸钙D3对COPD合并维生素D缺乏患者血钙水平及运动功能的影响

Influence of alfacalcidol combined with calcium carbonate D3 on serum calcium and motor function in patients with chronic obstructive pulmonary diseases complicated by vitamin D deficiency

目的探究口服阿法骨化醇联合碳酸钙D3对慢性阻塞性肺疾病(COPD)合并维生素D缺乏患者血钙和运动功能的影响。方法前瞻性队列研究。抽取2020年9月至2022年9月郑州大学第一附属医院收治的72例COPD合并维生素D缺乏患者,采用随机数字表法分为单药组和联合组,每组36例。单药组接受碳酸钙D3治疗,联合组接受阿法骨化醇联合碳酸钙D3治疗。比较两组干预前后血钙水平、25羟维生素D[25(OH)D]水平及6 min步行试验情况。比较两组不良反应发生情况。结果干预前,两组血钙水平、25(OH)D水平和6 min步行试验结果比较差异未见统计学意义(P>0.05)。干预后,两组血钙水平、25(OH)D水平均上升,且联合组水平高于单药组(P<0.05);干预后,两组6 min步行试验距离均增加,且联合组距离长于单药组(P<0.05)。联合组不良反应发生率(19.44%,7/36)高于单药组(13.89%,5/36),但差异未见统计学意义(P>0.05)。结论阿法骨化醇联合碳酸钙D3能较好地改善COPD合并维生素D缺乏患者的血钙水平和运动功能。

Objective To investigate the effect of alfacalcidol combined with calcium carbonate D3 on serum calcium and motor function in patients with chronic obstructive pulmonary disease(COPD)complicated by vitamin D deficiency.Methods Seventy-two patients with COPD complicated by vitamin D deficiency who treated in the First Affiliated Hospital of Zhengzhou University from September 2020 to September 2022 were selected for the prospective cohort study.And they were divided into the monotherapy group and the combination group by random number table method,with 36 cases in each group.The monotherapy group was treated with calcium carbonate D3,and the combination group received alfacalcidol combined with calcium carbonate for treatment.The levels of serum calcium and 25 hydroxyvitamin D,referred to as 25(OH)D,and six-minute walk test(6MWT)distance were compared between the two groups before and after intervention.The incidence of adverse reactions of the two groups were compared.Results Before intervention,there was no statistically significant difference in levels of serum calcium and 25(OH)D,and 6MWT distance between the two groups(P>0.05).After intervention,levels of serum calcium and 25(OH)D,increased in both groups,and the above indexes in the combination group were higher than those in the monotherapy group(P<0.05).After intervention,the distance of the 6MWT in both groups increased,and the distance in the combination group was longer than that in the monotherapy group(P<0.05).The adverse reaction rate in the combination group(19.44%,7/36)was higher than that in the monotherapy group(13.89%,5/36),but the difference between the two groups was not significant(P>0.05).Conclusions Alfacalcidol combined with calcium carbonate D3 has a better therapeutic effect on improving blood calcium level and motor function in COPD patients with vitamin D deficiency.