To investigate the risk factors of chronic pulmonary aspergillosis in patients with chronic obstructive pulmonary disease (COPD), and to analyze the clinical characteristics of different types of chronic pulmonary aspergillosis in COPD.

The patients with COPD complicated with chronic pulmonary aspergillosis diagnosed in the second affiliated Hospital of Army military Medical University from January 2015 to May 2020 were retrospectively collected as the case group, and the patients with COPD complicated with pulmonary infection (non-aspergillosis and non-pulmonary tuberculosis) were selected as the control group. Basic information, past history, medication, control of COPD, clinical symptoms, imaging features, inflammation and immune function were collected. The independent risk factors of COPD complicated with chronic pulmonary aspergillosis were analyzedby multivariate regression, and the clinical indexes of different types of chronic pulmonary aspergillosis were further analyzed and compared.

A total of 39 patients in the case group and 39 patients in the control group were included. The independent risk factors of COPD complicated with chronic pulmonary aspergillosis included acute exacerbation of COPD≥ 3 times in the past year, history of systemic hormone therapy in recent 3 months and previous history of pulmonary tuberculosis (P<0.05). Among the clinical indexes, there was no significant difference in general condition, inflammatory index and immune index between the two groups (P>0.05). Only the clinical symptoms of "sputum character change" and "hemoptysis" in the case group were more common than those in the control group (P<0.05). The difference was statistically significant (P<0.05). The clinical characteristics of different types of chronic pulmonary aspergillosis were analyzed. "Acute exacerbation of COPD≥3 times in the past year" , "C-reactive protein" , "absolute value of neutrophils" and "albumin" were significantly different among the three types (P<0.05).

The specificity of clinical characteristics of COPD complicated with chronic pulmonary aspergillosis have no obvious specificity. For COPD patients with pulmonary infection who have acute exacerbation of COPD≥3 times in the past year, or history of systemic hormone therapy in recent 3 months, or have a history of pulmonary tuberculosis, should consider the possibility of chronic pulmonary aspergillosis infection. Besides, the clinical characteristics of different types of chronic pulmonary aspergillosis are different, which has some guiding value for clinical differential diagnosis.