OBJECTIVE： To observe the effect and safety of dexamethasone combined with cefuroxime sodium in the treatment of AECOPD （acute exacerbation of chronic obstructive pulmonary disease） complicated with pulmonary emphysema. METHODS： The data of 80 AECOPD patients complicated with pulmonary emphysema was retrospectively analyzed and patients were divided into test group and control group by different administration， 40 cases in each group. All patients rest on bed immediately after admission， then given nutritional support to maintain electrolyte balance and other symptomatic and supportive treatment， based on it， control group received 1.5 g Cefuroxime sodium injection adding into 100 ml 0.9％ Sodium chloride solution by intravenous infusion，twice / d （if the anti-infection effect was not good， the dose was increased to 2.0 g）. observation group was additionally given dexamethasone Sodium phosphate injection 5 mg adding into 20 ml of 0.9％ Sodium chloride solution by inhaling， twice/d. Two groups were treated for 1 week. The pulmonary functions [including 6-minute walk test （6MWT），vital capacity（FVC）， forced expiratory volume in 1 second （FEV1）， FEV1/FVC， mid-expiratory flow rate （MMEF）， maximum expiratory flow rate （PEF） levels] before and after treatment， inflammatory cytokine levels [including polymorphonuclear leukocytes （PMN），IL-8， IL-17， high-sensitivity C-reactive protein （hs-CRP）， tumor necrosis factor （TNF-α）]， airway resistance [including the total respiratory impedance （Z5）， resonant frequency （Fres）， total airway resistance （R5）]， liver and kidney function indicators [including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， urea nitrogen （BUN）， creatinine （Scr）， urea nitrogen（Ucr）] in 2 groups were observed. RESULTS： Before treatment， there were no significant differences in pulmonary functions， inflammatory cytokine levels and airway resistance related indicators in 2 groups（P＞0.05）. After treatment， pulmonary function related indicators in 2 groups were significantly higher than before， and observation group was higher than control group， inflammatory cytokine levels and airway resistance related indicators were significantly lower than before， and observation group was lower than control group， with statistical significances（P＜0.05）. In terms of safety， ALT， AST， BUN， Scr， Ucr before and after treatment in 2 groups were all within the normal range. CONCLUSIONS： Dexamethasone combined with cefuroxime sodium has good therapeutic effect on patients AECOPD complicated with emphysema， which can significantly improve the pulmonary functions and reduce airway resistance in patients， with good safety.