Abstract： Objective To explore the predictive value of Neutrophil-to-lymphocyte ratio(NLR)and fibrinogen-to-albumin ratio(FAR)for elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmo-nary hypertension.Methods A total of 50 elderly AECOPD patients with pulmonary hypertension who were hospitalized in the First Hospital of Shanxi Medical University from January to June 2021 were selected as the combined group,and 61 elderly AECOPD pa-tients without pulmonary hypertension during the same period were selected as the control group.The clinical data and laboratory pa-rameters of the patients at admission were collected,the risk factors of pulmonary hypertension in elderly patients with AECOPD were analyzed by multivariate logistic regression,and the predictive value of NLR and FAR for pulmonary hypertension in elderly patients with AECOPD was evaluated by ROC curve.Results There were significant differences in age,body mass index,length of hospital stay,AECOPD severity grade,use of ventilator,intravenous hormone therapy,antibiotic course,NLR,FAR,white blood cell count,neutrophil count,hemoglobin,fibrinogen,D-dimer,procalcitonin,B-type natriuretic peptide,partial pressure of carbon dioxide,right atrial diameter,right ventricular diameter,lymphocyte count,eosinophil count,albumin,oxygenation index,left atrial diameter and left ventricular end-diastolic diameter between the two groups(P<0.05).Multivariate logistic regression analysis showed that NLR and FAR were independent risk factors for pulmonary hypertension in elderly patients with AECOPD(P<0.05).ROC curves showed that NLR combined with FAR had the highest predictive value for pulmonary hypertension.Conclusion NLR and FAR have a certain predictive value for elderly AECOPD patients with pulmonary hypertension,and their combined use has a better predictive effect.