目的探讨慢性阻塞性肺疾病(COPD)继发肺部曲菌感染的临床特征、危险因素及诊断。方法回顾性分析20例COPD的临床资料并进行相关文献复习。结果 20例患者均是在治疗慢性阻塞性肺疾病过程中突然出现病情变化:15例出现胸闷加重,3例出现高热38～39℃,2例出现胸痛,1例出现咯血。影像学表现为:5例出现大片密度增高影,5例出现点片状网织阴影,3例出现多发小空洞影,3例片状影,3例出现多发结节影,1例出现空洞结节,伴空气新月征。20例患者治愈5例,死亡15例。结论 COPD继发曲菌感染,临床症状较重,死亡率高。广谱抗感染药物、糖皮质激素应用、侵袭性操作等是其发病的高危因素,及早诊断及时治疗可降低死亡率。 Objective To investigate the clinical characteristics, risk factors and diagnosis of pulmonary aspergillosis secondary to chronic obstructive pulmonary disease (COPD). Methods The clinical data of 20 cases of COPD were retrospectively analyzed and the related literatures were reviewed. Results All the 20 patients experienced sudden changes in the course of treating chronic obstructive pulmonary disease: 15 cases had increased chest tightness, 3 cases had high fever 38-39 ℃, 2 cases had chest pain and 1 case had hemoptysis. Imaging findings were as follows: 5 cases showed large shadow of increased density, 5 cases showed patchy reticular shadows, 3 cases showed multiple small hollow-hole shadow, 3 cases of patchy shadow, 3 cases of multiple nodules, 1 case of hollow knot Festival, with air crescent sign. Twenty patients were cured in 5 cases and 15 died. Conclusion COPD secondary to Aspergillus infection, severe clinical symptoms, high mortality. Broad-spectrum anti-infectives, glucocorticoid use and invasive procedures are risk factors for their morbidity. Early diagnosis and prompt treatment reduce mortality.