الفهرس 
Acute exacerbations of COPDOnly 14 pages are availabe for public view
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Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/ or alveolar abnormalities usually caused by significant exposure to noxious particles or gases, COPD is listed as the fourth leading cause of death world wide.
Exacerbation of COPD is defined as an acute worsening of respiratory symptoms that results in additional therapy.
Exacerbations of COPD are important events in the management of COPD because they negatively impact healthy status, rates of hospitalization and re-admission and disease progression .
COPD exacerbations frequently lead to an increase in health care resource use, according to severity. For example, mild exacerbations can often be managed in the home but may require increased use of reliever medication, such as inhaled bronchodilators, for worsening symptoms, while moderate exacerbations need treatment with antibiotics and/or corticosteroids. Severe exacerbations require hospitalization for advanced monitoring and potential treatments, including assisted ventilation .
Magnesium is involved in such important functions as bronchodilation and contraction in respiratory tract smooth muscles , mast cell stabilization, neurohumoral mediator release, and mucociliary clearance , magnesium is thought to have a protective effect against chronic respiratory tract diseases.
Hypomagnesemia is associated with increased airway hyperreactivity and decreased muscle strength. Hypomagnesemia is one of the correctable risk factor, Thus, Mg+2 may have a role in maintaining disease stability in COPD patients.
The aim of this study was to determine the association of serum magnesium level in COPD patients and its relationship with frequency of exacerbations .
This study was a Prospective study which included 150 subject divided into 2 groups: group A included 30 apparently healthy individuals and group B included 120 COPD patients attended at Benha university hospital chest department in acute exacerbation of COPD or stable COPD patients who came for follow up in the period between May 2021 and February 2022.
All patients were subjected to the following:
1. Full medical history.
2. Thorough physical examination.
3. Routine laboratory investigations in the form of:
Complete Blood picture, erythrocyte sedimentation rate (ESR), coagulation profile.
Liver function tests .
Kidney function tests .
Arterial blood gases .
4-Radiological examination including:
Plain chest X-ray postero-anterior and lateral views.
5-PFT (spirometry) .
6-Level of serum Mg .
from the current study it was found that:
There was no significant difference between the three studied groups regarding demographic data.
There was significant difference between the three studied groups regarding dyspnea, cough & expectoration, cyanosis, wheeze and flap
There was highly statistically significant difference between mean serum magnesium in stable and exacerbated COPD patients
Decrease serum Mg associated with icrease severity of both stable and AECOPD & increase frequency of admission.
Regarding smoking index, there was significant inverse correlation between serum Mg and smoking index among the studied groups.
serum magnesium level is a valuable predictor of occurrence of exacerbations in COPD. Area under curve (AUC) was determined as = .807, at a cut-off value of 1.91 mg/dL to diagnose exacerbation , and with a sensitivity of 94% and specificity of 98%.