Objective  To investigate the correlations of serum hypoxia inducible factor-1α (HIF-1α), pro-adrenomedullin (pro-ADM) and glycocholic acid (CG) levels with progress of lung function injury in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

  Methods  Ninety-one patients with AECOPD were prospectively selected as research subjects. Serum HIF-1α, pro-ADM and CG levels were detected on admission, and followed up for one year after treatment. Patients with lung function injury were counted and divided into lung function injury exacerbation group (n=23) and lung function injury without exacerbation group (n=68). The correlations of serum HIF-1α, pro-ADM and CG levels with exacerbation of lung function injury in patients with AECOPD were analyzed.

  Results  The proportion of exacerbation of lung function injury in AECOPD patients was 25.27%; the serum HIF-1α, pro-ADM and CG levels of the lung function injury exacerbation group were significantly higher than those of the lung function injury without exacerbation group (P < 0.05). The high expression levels of serum HIF-1α, Pro-ADM and CG were the influencing factors for the exacerbation of lung function injury in patients with AECOPD (OR>1, P < 0.05). The area under the curve (AUC) of serum HIF-1α, pro-ADM and CG levels predicting the risk of exacerbating lung function injury in AECOPD patients were all greater than 0.80.

  Conclusion  The high expression levels of serum HIF-1α, pro-ADM and CG may be associated with the exacerbation of lung function injury in elderly patients with AECOPD. Early detection of serum HIF-1α, pro-ADM and CG levels can predict lung function injury in elderly patients with AECOPD.