Abstract: Objective To investigate the expression of serum high mobility group protein B1 (HMGB1) in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the intervention effect of N-acetylcysteine effervescent tablets. Methods From January 2018 to October 2019, 82 elderly patients with AECOPD were selected as AECOPD group; 71 elderly patients with stable COPD treated at the same time were selected as COPD group, and 51 cases of healthy physical examination were selected as control group. Enzyme-linked immunosorbent assay was used to detect the levels of HMGB1 and tumor necrosis factor-α (TNF-α) in the three groups. According to whether they were treated with N-acetylcysteine effervescent tablets, the AECOPD patients were divided into used group and non-used group, with 41 cases in each group. The levels of HMGB1, TNF-α, lung function and COPD assessment test (CAT) score between the two groups before and after treatment were compared. Results The levels of HMGB1 and TNF-α in the AECOPD group were higher than those in the COPD group and the control group (P<0. 05). The levels of HMGB1 and TNF-α in the COPD group were higher than those in the control group (P<0. 05). In the AECOPD group, the levels of HMGB1 and TNF-α in severe patients were higher than those in mild and moderate patients (P<0. 05). After treatment, the levels of HMGB1, TNF-α and CAT scores in AECOPD patients were lower than before treatment(P<0. 05). The levels of HMGB1, TNF-α and CAT scores after treatment in the used group were lower than those in the non-used group (P<0. 05). The pulmonary function of AECOPD patients were improved after 1 month of intervention, and the levels of forced vital capacity rate of one second (FEV1), forced vital capacity (FVC) and FEV1/FVC in the used group were higher than those of the non-used group(P<0. 05). The incidence rate of nausea and vomiting, diarrhea, constipation, blood pressure fluctuation, liver and kidney abnormalities during the treatment between the AECOPD subgroups showed no statistically significant difference (P>0. 05). Conclusions HMGB1 is highly expressed in the elderly patients with AECOPD. On the basis of conventional treatment, N-acetylcysteine effervescent tablets can reduce the levels of HMGB1 and TNF-α and improve patients’ lung function, which is worthy of promotion and application.

Key words: serum high mobility group protein B1, chronic obstructive pulmonary disease, acute exacerbation, N-acetylcysteine effervescent tablet, aged