Abstract： Objective To investigate the chronic obstructive pulmonary disease with acute exacerbation(AE-COPD) of eonseiousneas. Methods For January 2004 to June 2008, AECOPD clinical data were reviewed retroepec-tively. Results 5 yeats treated 310 eases with AECOPD,impaired consciousness occurred in 16. 8% (52/310) : 29cases of pulmonary encephalopathy, hypotonic encephalopathy 12 cases ,5 cases of cerebral infarctinn,4 cases of drug-induced;clinical symptoms often show a variety,may be characteristic,but the cause of death by up to 55.6% of the total number of deaths(10/18). Conclusion AECOPD had high incidence of disturbance of eonseiousneas,and it isdiflleult to avoid completely;should pay attention to identify,first perform head CT or MR/examination to exclude or-ganic brain disease,according to arterial blood gas analysis,bloed electrolyte,to further determine the cause.