Abstract: Objective: To investigate the risk factors,clinical features and prognosis of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods: The etiology and treatment of 286 patients with COPD were retrospectively analyzed.Results: Among 226 patients,the respiratory infection and physical and chemical factors were the inducing factor and main factors of disease,respectively.The emotional stress,electrolyte disorder,insomnia,drug withdrawal,spontaneous pneumothorax and pulmonary embolism could aggravate the diseases,and the levels of C-reactive protein and neutrophil increased obviously in 226 patients.The FEV1.0 in 278 patients decreased.The risk of death in patients with multiple organ disease,multiple drug-resistant bacteria infection,repeated mechanical ventilation and hypoalbuminemia was large.Conclusions: Respiratory infection and physical and chemical factors are the main causes of the acute exacerbation of COPD.Clinical manifestations and laboratory examination results are inconsistent,the fatality rate of patients with complex conditions is high,which should be greatly paid attention to.