Abstract: Objective To study the predictive value of prealbumin(PA)and albumin level for prognosis of patients with severe chronic obstructive pulmonary disease(COPD).Methods The study selected 107 patients with severe COPD,the serum protein of initial and 72 hours in intensive care unit was detected.According to the initial albumin levels,the patients were divided into albumin < 30 g/L group and albumin ≥ 30 g/L group,comparison was made in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,initial albumin level,the time of mechanical ventilation,and the case fatality rate of 28 days of two groups.After 28 days,outcome was divided into death group and alive group,observation was performed on the dynamic change of serum protein level.Results The APACHE Ⅱ score,mechanical ventilation time and case fatality rate of 28 days in albumin ≥ 30 g/L group were significantly lower than those in albumin <30 g/L group(P <0.01).Initial PA level of albumin ≥30 g/L group was significantly higher than that of albumin <30 g/L group(P <0.01).PA level of survival group was higher than that of death group at 0 h and 72 h(P <0.01).PA level of survival group at 72 h was above the 0 h(P < 0.01).The albumin level of survival group at 72 h showed no significant difference as compared with that of 0 h(P >0.05).PA and albumin level of death group at 72 h also showed no significant difference as compared with those of 0 h(P >0.05).Conclusion Serum protein level is an important predictor of severity and prognosis for severe COPD patients.

Key words: pulmonary disease, chronic obstructive, prealbumin, albumins, prognosis