Abstract: Objective To investigate the dynamic changes and clinical significance of high mobility group box 1(HMGB1) and neutrophil elastase (NE) in the elderly patients with both acute stage COPD and stable COPD. Methods Fifty-six elderly patients with both acute stage COPD and stable COPD were investigated as the study group,while thirty-five elderly healthy people were investigated as the control group.The expression of serum HMGB1 and NE were measured by ELISA in the three groups. Results ①The level of HMGB1 in three groups were (12.86±3.81) ng/ml,(6.37±1.86) ng/ml,(4.13±0.87) ng/ml,and the level of NE in three groups were (5.67±0.87) nmol/L,(2.71±0.72) nmol/L,(0.86±0.12) nmol/L.②The level of HMGB1 and NE in the elderly patients with acute stage COPD was significantly higher than the elderly patients with stable COPD and the control group,which had statistical significance (P<0.05).③The level of HMGB1 and NE in the elderly patients with stable COPD were higher than that in the control group,with statistical significance (P<0.05).④The level of HMGB1 and NE was in significantly positive correlation (r=0.918,P<0.05).The level of HMGB1 was inversely related to pulmonary function index (r=-0.923,-0.929,P<0.05).The level of NE was inversely related to pulmonary function index (r=-0.927,-0.912,P<0.05). Conclusion Inflammatory mechanisms played an important role in the pathogenesis of the COPD.Detecting the change of HMGB1 and NE in elderly COPD patients played very important basis on the clinical diagnose and the pathogenic mechanism.