血磷、血镁水平与老年COPD急性加重患者病情及预后的关系

doi:10.11958/20253577

天津医药 ›› 2026, Vol. 54 ›› Issue (7): 765-770.doi: 10.11958/20253577

血磷、血镁水平与老年COPD急性加重患者病情及预后的关系

钱进¹(), 魏夕阳¹^,^△(), 徐冲²

¹ 无锡市锡山区中医医院老年医学科（邮编214199）
² 无锡市锡山区中医医院内科（邮编214199）

收稿日期:2025-12-11 修回日期:2026-01-21 出版日期:2026-07-15 发布日期:2026-07-13
通讯作者: ^△E-mail:593116108@qq.com
作者简介:钱进（1980），男，主治医师，主要从事老年呼吸、神经疾病方面研究。E-mail：jin_j18@163.com
基金资助:
无锡市中医药管理局科技项目(ZYYB15)

Association between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of COPD

QIAN Jin¹(), WEI Xiyang¹^,^△(), XU Chong²

¹ Department of Geriatrics, Xishan District Traditional Chinese Medicine Hospital, Wuxi 214199, China
² Department of Internal Medicine, Xishan District Traditional Chinese Medicine Hospital, Wuxi 214199, China

Received:2025-12-11 Revised:2026-01-21 Published:2026-07-15 Online:2026-07-13
Contact: ^△E-mail:593116108@qq.com

钱进, 魏夕阳, 徐冲. 血磷、血镁水平与老年COPD急性加重患者病情及预后的关系[J]. 天津医药, 2026, 54(7): 765-770.

QIAN Jin, WEI Xiyang, XU Chong. Association between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of COPD[J]. Tianjin Medical Journal, 2026, 54(7): 765-770.

摘要/Abstract

摘要：

目的探讨血磷、血镁水平与老年慢性阻塞性肺疾病急性加重（AECOPD）患者病情及预后的关系。方法选取158例老年AECOPD患者作为研究对象，按病情分为轻度组（52例）、中度组（46例）、重度组（60例），比较各组的血磷、血镁水平及肺功能指标。采用Pearson相关分析血磷、血镁与病情指标的相关性，根据随访6个月的预后情况分为预后良好组（116例）和预后不良组（42例）。收集并比较2组一般及临床资料，单因素及多因素Logistic回归分析预后影响因素，采用受试者工作特征（ROC）曲线分析相关因素对老年AECOPD患者预后不良的预测价值。结果重度组血磷、血镁、第1秒用力呼气容积占预计值的百分比（FEV1%预计值）和第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC）低于轻度组和中度组，CURB-65评分高于轻度组和中度组（P<0.05）；血磷、血镁与CURB-65评分呈负相关（r分别为-0.369、-0.283，P<0.05），与FEV1%预计值和FEV1/FVC呈正相关（r分别为0.387、0.281及0.220、0.171，P<0.05）。单因素及多因素Logistic回归分析发现，年龄较大是老年AECOPD患者预后不良的独立危险因素，FEV1%预计值、血磷、血镁升高是独立保护因素（均P<0.05）；ROC曲线分析显示，年龄、FEV1%预计值、血磷、血镁联合预测的曲线下面积（AUC）高于单项检测（Z分别为4.643、3.745、4.411、4.327，P<0.05）。结论血磷、血镁水平与老年AECOPD患者病情严重程度相关，年龄、FEV1%预计值、血磷、血镁对预后具有独立预测价值，联合检测可提高预测效能。

关键词: 肺疾病, 慢性阻塞性, 磷, 镁, 预后, 老年人, 急性加重

Abstract:

Objective To investigate the relationship between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 158 elderly AECOPD patients admitted to our hospital from January 2022 to December 2024 were enrolled as the study subjects. Patients were divided into the mild group (n=52), the moderate group (n=46) and the severe group (n=60) based on disease severity. Serum phosphorus and magnesium levels, as well as pulmonary function indices, were compared between the groups. Pearson correlation analysis was performed to assess the relationship between serum phosphorus/magnesium levels and disease-related indicators. According to the prognosis after 6-month follow-up, patients were categorized into the good prognosis group (n=116) and the poor prognosis group (n=42). The general and clinical data of the two groups were collected and compared. Univariate and multivariate Logistic regression analyses were performed to identify prognostic factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of relevant factors in predicting poor prognosis in elderly patients with AECOPD. Results The serum phosphorus and magnesium levels, the percentage of forced expiratory volume in 1 second to the predicted value (FEV1% predicted) and the percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) were lower in the severe group than those in the mild group and the moderate group, but the CURB-65 score was higher in the severe group compared to the mild group and the moderate group (P<0.05). Serum phosphorus and magnesium levels were negatively correlated with the CURB-65 score (r=-0.369 and -0.283, respectively, P<0.05) and positively correlated with FEV1% predicted value and FEV1/FVC (r=0.387, 0.281 for phosphorus; r=0.220, 0.171 for magnesium; P<0.05). Both univariate and multivariate Logistic regression analyses indicated that older age was an independent risk factor for poor prognosis in elderly AECOPD patients, whereas higher FEV1% predicted value, serum phosphorus and serum magnesium levels were independent prediction factors (all P<0.05). ROC curve analysis demonstrated that the area under the curve (AUC) of the combined prediction of age, FEV1% predicted value, serum phosphorus and serum magnesium was higher than that of the individual indicators (Z=4.643, 3.745, 4.411, 4.327, respectively; P<0.05). Conclusion Serum phosphorus and magnesium levels are correlated with the severity of AECOPD in elderly patients. Age, FEV1% predicted value, serum phosphorus and serum magnesium levels possess independent predictive value for prognosis, and their combined assessment enhances predictive efficacy.

Key words: pulmonary disease, chronic obstructive, phosphorus, magnesium, prognosis, aged, acute exacerbation

中图分类号:

R563

图/表 6

参考文献 21

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组别	n	血磷/（mmol/L）	血镁/（mmol/L）	CURB-65评分/分	FEV1%预计值/%	FEV1/FVC/%
轻度组	52	1.17±0.30	0.91±0.20	1.04±0.21	62.04±8.48	58.64±4.81
中度组	46	1.02±0.27^a	0.88±0.17^a	2.07±0.31^a	50.23±6.20^a	52.43±4.29^a
重度组	60	0.88±0.20^ab	0.78±0.15^ab	2.88±0.43^ab	42.43±7.14^ab	49.68±7.01^ab
F		18.081^＊＊	7.954^＊＊	419.805^＊＊	99.219^＊＊	36.410^＊＊

组别	n	血磷/（mmol/L）	血镁/（mmol/L）	CURB-65评分/分	FEV1%预计值/%	FEV1/FVC/%
轻度组	52	1.17±0.30	0.91±0.20	1.04±0.21	62.04±8.48	58.64±4.81
中度组	46	1.02±0.27^a	0.88±0.17^a	2.07±0.31^a	50.23±6.20^a	52.43±4.29^a
重度组	60	0.88±0.20^ab	0.78±0.15^ab	2.88±0.43^ab	42.43±7.14^ab	49.68±7.01^ab
F		18.081^＊＊	7.954^＊＊	419.805^＊＊	99.219^＊＊	36.410^＊＊

组别	n			年龄/岁	性别（男/女）			体质量指数/（kg/m²）			受教育程度（高中及以下/大专及以上）			居住地（城镇/农村）		吸烟			饮酒		高血压		糖尿病			冠心病
预后良好组	116			71.70±5.35	82/34			22.30±2.64			75/41			68/48		80（68.97）			45（38.79）		52（44.83）		30（25.86）			28（24.14）
预后不良组	42			76.66±5.75	32/10			21.76±2.28			30/12			22/20		32（76.19）			14（33.33）		22（52.38）		14（33.33）			13（30.95）
t或χ²				5.046^＊＊	0.464			1.179			0.635			0.490		0.780			0.393		0.707		0.857			0.745
组别			COPD病程/年				WBC/（×10⁹/L）			LY/（×10⁹/L）			NE/（×10⁹/L）				HGB/（g/L）			PLT/（×10⁹/L）				ALT/（U/L）
预后良好组			8.85±2.30				10.91±2.75			1.11±0.33			8.10±2.50				134.05±16.92			209.86±45.29				27.13（20.36，32.48）
预后不良组			8.80±2.71				11.63±2.89			1.04±0.34			8.55±2.26				131.92±13.26			226.00±50.09				29.83（22.43，36.39）
t或Z			0.109				1.443			1.106			1.019				0.736			1.923				1.019
组别		AST/（U/L）				ALB/（g/L）			TG/（mmol/L）			TC/（mmol/L）			FEV1%预计值/%			FEV1/FVC/%				血磷/（mmol/L）			血镁/（mmol/L）
预后良好组		25.21（20.04，31.22）				35.81±3.40			1.36±0.31			4.20±0.83			45.69±8.36			57.39±9.06				0.90±0.31			0.85±0.20
预后不良组		27.02（25.83，37.32）				35.53±3.85			1.33±0.29			4.10±0.91			36.88±7.15			54.97±9.25				0.68±0.21			0.67±0.20
Z或t		1.622				0.442			0.595			0.615			6.075^＊＊			1.475				4.279^＊＊			4.686^＊＊

组别	n			年龄/岁	性别（男/女）			体质量指数/（kg/m²）			受教育程度（高中及以下/大专及以上）			居住地（城镇/农村）		吸烟			饮酒		高血压		糖尿病			冠心病
预后良好组	116			71.70±5.35	82/34			22.30±2.64			75/41			68/48		80（68.97）			45（38.79）		52（44.83）		30（25.86）			28（24.14）
预后不良组	42			76.66±5.75	32/10			21.76±2.28			30/12			22/20		32（76.19）			14（33.33）		22（52.38）		14（33.33）			13（30.95）
t或χ²				5.046^＊＊	0.464			1.179			0.635			0.490		0.780			0.393		0.707		0.857			0.745
组别			COPD病程/年				WBC/（×10⁹/L）			LY/（×10⁹/L）			NE/（×10⁹/L）				HGB/（g/L）			PLT/（×10⁹/L）				ALT/（U/L）
预后良好组			8.85±2.30				10.91±2.75			1.11±0.33			8.10±2.50				134.05±16.92			209.86±45.29				27.13（20.36，32.48）
预后不良组			8.80±2.71				11.63±2.89			1.04±0.34			8.55±2.26				131.92±13.26			226.00±50.09				29.83（22.43，36.39）
t或Z			0.109				1.443			1.106			1.019				0.736			1.923				1.019
组别		AST/（U/L）				ALB/（g/L）			TG/（mmol/L）			TC/（mmol/L）			FEV1%预计值/%			FEV1/FVC/%				血磷/（mmol/L）			血镁/（mmol/L）
预后良好组		25.21（20.04，31.22）				35.81±3.40			1.36±0.31			4.20±0.83			45.69±8.36			57.39±9.06				0.90±0.31			0.85±0.20
预后不良组		27.02（25.83，37.32）				35.53±3.85			1.33±0.29			4.10±0.91			36.88±7.15			54.97±9.25				0.68±0.21			0.67±0.20
Z或t		1.622				0.442			0.595			0.615			6.075^＊＊			1.475				4.279^＊＊			4.686^＊＊

变量	β	SE	Wald χ²	P	OR	95%CI
年龄	0.121	0.031	14.989	<0.001	1.128	1.061~1.199
FEV1%预计值	-0.147	0.030	24.018	<0.001	0.863	0.814~0.915
血磷	-0.282	0.073	15.032	<0.001	0.754	0.654~0.870
血镁	-0.409	0.100	16.627	<0.001	0.665	0.546~0.809

血磷、血镁水平与老年COPD急性加重患者病情及预后的关系

Association between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of COPD

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变量	β	SE	Wald χ²	P	OR	95%CI
年龄	0.135	0.041	10.684	0.001	1.145	1.056~1.242
FEV1%预计值	-0.138	0.034	16.050	<0.001	0.871	0.815~0.932
血磷	-0.319	0.102	9.770	0.002	0.727	0.595~0.888
血镁	-0.464	0.127	13.350	<0.001	0.629	0.490~0.806
常数项	0.643	3.281	0.038	0.845	1.903

项目	AUC		95%CI		P		约登指数
年龄	0.689		0.611~0.760		0.001		0.306
FEV1%预计值	0.793		0.721~0.853		<0.001		0.512
血磷	0.713		0.636~0.782		<0.001		0.339
血镁	0.721		0.644~0.789		<0.001		0.356
联合	0.908		0.852~0.948		<0.001		0.719
项目		截断值		敏感度/%		特异度/%
年龄		78.088岁		45.24		85.34
FEV1%预计值		39.902%		76.19		75.00
血磷		0.776 mmol/L		66.67		67.24
血镁		0.698 mmol/L		57.14		78.45
联合		-		85.71		86.21

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