Abstract: Objective: To explore the composition and dynamic trajectory of symptom clusters in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 185 patients with AECOPD from The Bozhou Hospital of Anhui Medical University from January 2020 to October 2024 were selected as the study subjects by using convenience sampling method.General information questionnaire,Chinese version memorial symptom assessment scale,modified Medical Research Council dyspnea scale,Pittsburgh sleep quality index,hospital anxiety and depression scale were used to assess the symptoms of patients with AECOPD on the first day of hospitalization (T1),the day of discharge (T2),and one month after discharge (T3).Exploratory factor analysis was conducted to identify and extract symptom clusters,followed by the use of group-based trajectory modeling to identify the patients' development trajectory. Results: Patients with AECOPD exhibited an incidence rate of over 50% for 18 symptoms at admission,13 symptoms on the day of discharge,and 6 symptoms one month after discharge.Exploratory factor analysis identified 5 symptom clusters,which were named as the water-sodium gastrointestinal symptom cluster,self-image disturbance cluster,related psychological and emotional symptom cluster,respiratory-related symptom cluster,and sleep-fatigue-appetite symptom cluster.Through trajectory modeling,three heterogeneous population trajectories were identified:high-level rapid remission type,high-level stable remission type,and low-level stable remission type.The influencing factors were sex and the number of combined chronic diseases. Conclusions: The symptom clusters of patients with AECOPD exhibit a longitudinal change trend over time.Nursing staff should focus on the psychological conditions and fatigue-sleep symptom cluster in patients with AECOPD.