Research status and hotspot analysis of acute exacerbation of chronic obstructive pulmonary disease based on bibliometrics_West China Medical Journal

Authors：

JIA Mingyan ^1,2,3 , XIE Kai ^1,2,3 ,  WANG Haifeng ^1,2,3

1. National Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, the First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan 450000, P. R. China;
2. The First Clinical Medical College of Henan University of CM, Zhengzhou, Henan 450000, P. R. China;
3. Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of China, Zhengzhou, Henan 450046, P. R. China;

Corresponding author：

WANG Haifeng, Email: wangh_f@126.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; bibliometrics; research progress; hotspot analysis; CiteSpace

DOI：

10.7507/1002-0179.202501180

Video：

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Objective To analyze and summarize the research status, hotspots, and development trends in the field of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods The AECOPD-related literature from 2013 to 2023 was retrieved from the China National Knowledge Infrastructure and Web of Science. Based on bibliometric methods, CiteSpace 6.2.R2 and Excel software were used to analyze the journals, authors, institutions, and keywords of AECOPD-related Chinese and English literature. Results Finally, 802 Chinese literature and 3478 English literature were included. The number of Chinese studies on AECOPD had shown a relatively stable trend in the past decade. The number of English studies on AECOPD showed a fluctuating upward trend, reaching its peak in 2021 and then slightly decreasing. The overall number of studies showed a fluctuating upward trend. Compared to Chinese literature authors, English literature authors collaborated more closely. Prior to 2017, Chinese literature mainly focused on the inflammatory mechanisms, bacterial infections, and antibiotic treatment of AECOPD. From 2017 to 2023, attention had been paid to bacterial resistance, traditional Chinese medicine syndrome types, influencing factors, and prognostic nursing. The pathogenesis of inflammation continued to be closely monitored, while also paying attention to oxidative stress mechanisms. The English literature from 2013 to 2018 mainly focused on the clinical outcomes, clinical trials, pathological studies, and antibiotic treatment of AECOPD, with a particular emphasis on its comorbidities with cardiovascular diseases such as myocardial infarction. From 2019 to 2023, the main focus was on the global burden and medical insurance utilization of AECOPD, as well as its pathogenesis, with a particular emphasis on micro level research on the lung microbiome and cell related aspects. Conclusion At present, the publication volume of AECOPD topics is showing a fluctuating upward trend, the disciplinary fields are constantly expanding, and research hotspots are constantly moving forward, receiving widespread attention both domestically and internationally. The overall development trend of related research is good, and cooperation should be strengthened to conduct more in-depth research.

Citation： JIA Mingyan, XIE Kai, WANG Haifeng. Research status and hotspot analysis of acute exacerbation of chronic obstructive pulmonary disease based on bibliometrics. West China Medical Journal, 2026, 41(1): 72-78. doi: 10.7507/1002-0179.202501180 Copy

1.	GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med, 2017, 5(9): 691-706.
2.	Han W, Wang M, Xie Y, et al. Prevalence of pulmonary embolism and deep venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 732855.
3.	Fang H, Zhang H, Wang Z, et al. Systemic immune-inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal, 2020, 34(1): e23016.
4.	Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J, 2018, 52(5): 1801261.
5.	尹美玲, 孙晓媛, 岳利峰, 等. 基于文献计量学的国内外睡眠障碍研究现状与热点分析. 世界科学技术-中医药现代化, 2022, 24(1): 436-445.
6.	Yao L, Hui L, Yang Z, et al. Freshwater microplastics pollution: detecting and visualizing emerging trends based on Citespace II. Chemosphere, 2020, 245: 125627.
7.	冯贞贞, 何雯青, 谢洋, 等. 慢性阻塞性肺疾病急性加重期证候疗效评价量表初步研制. 中国中西医结合杂志, 2023, 43(5): 564-571.
8.	何雯青, 冯贞贞, 春柳, 等. 慢性阻塞性肺疾病急性加重期证候疗效评价要素研究——基于文献研究结合专家咨询. 中医杂志, 2022, 63(5): 481-487.
9.	王至婉, 李羚, 李建生, 等. 基于贝叶斯网络的慢性阻塞性肺疾病急性加重期证候与症状间的关联模式. 中华中医药杂志, 2019, 34(9): 3964-3969.
10.	王露, 张海龙, 张东, 等. 中药治疗慢性阻塞性肺疾病急性加重系统评价/Meta 分析的质量评价. 中国老年学杂志, 2021, 41(14): 2968-2972.
11.	谢洋, 王佳佳, 李宣霖, 等. 针刺治疗慢性阻塞性肺疾病急性加重期的临床研究文献分析. 中国老年学杂志, 2019, 39(13): 3151-3154.
12.	王明航, 毕丽婵, 赵欢欢, 等. 慢性阻塞性肺疾病急性加重再入院影响因素. 中国老年学杂志, 2022, 42(13): 3354-3356.
13.	王明航, 陈学昂, 李晓俊, 等. 基于临床研究数据的慢性阻塞性肺疾病急性加重风险因素的筛选. 中华中医药杂志, 2019, 34(10): 4839-4846.
14.	Bhatt SP, Agusti A, Bafadhel M, et al. Phenotypes, etiotypes, and endotypes of exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2023, 208(10): 1026-1041.
15.	Han MK, Tayob N, Murray S, et al. Predictors of chronic obstructive pulmonary disease exacerbation reduction in response to daily azithromycin therapy. Am J Respir Crit Care Med, 2014, 189(12): 1503-1508.
16.	Bhatt SP, Connett JE, Voelker H, et al. β-Blockers for the prevention of acute exacerbations of chronic obstructive pulmonary disease (βLOCK COPD): a randomised controlled study protocol. BMJ Open, 2016, 6(6): e012292.
17.	Singh D, Criner GJ, Dransfield MT, et al. Informing the pathway of COPD treatment (IMPACT) trial: fibrinogen levels predict risk of moderate or severe exacerbations. Respir Res, 2021, 22(1): 130.
18.	Han MK, Quibrera PM, Carretta EE, et al. Frequency of exacerbations in patients with chronic obstructive pulmonary disease: an analysis of the SPIROMICS cohort. Lancet Respir Med, 2017, 5(8): 619-626.
19.	Leitao Filho FS, Mattman A, Schellenberg R, et al. Serum IgG levels and risk of COPD hospitalization a pooled meta-analysis. Chest, 2020, 158(4): 1420-1430.
20.	Crisan L, Wong N, Sin DD, et al. Karma of cardiovascular disease risk factors for prevention and management of major cardiovascular events in the context of acute exacerbations of chronic obstructive pulmonary disease. Front Cardiovasc Med, 2019, 6: 79.
21.	Kunisaki KM, Dransfield MT, Anderson JA, et al. Exacerbations of chronic obstructive pulmonary disease and cardiac events. a post hoc cohort analysis from the SUMMIT randomized clinical trial. Am J Respir Crit Care Med, 2018, 198(1): 51-57.
22.	Dransfield MT, Criner GJ, Halpin D, et al. Time-dependent risk of cardiovascular events following an exacerbation in patients with chronic obstructive pulmonary disease: post hoc analysis from the IMPACT trial. J Am Heart Assoc, 2022, 11(18): e24350.
23.	Agusti A, Celli BR, Criner GJ, et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. Respirology, 2023, 28(4): 316-338.
24.	Du X, Chen Y, Zhang R, et al. Effects of Qingjin Huatan decoction on pulmonary function and inflammatory mediators in acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Front Pharmacol, 2024, 15: 1466677.
25.	宋卫珍, 董凌云. 噻托溴铵吸入剂联合布地奈德福莫特罗治疗对老年急性加重期 COPD 患者肺功能及对 HMGB1、Copeptin 的影响. 中国老年学杂志, 2020, 40(9): 1847-1851.
26.	何淑霞, 俞峭拔, 孙小丽, 等. 硫酸沙丁胺醇联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期患者的临床研究. 中国临床药理学杂志, 2020, 36(12): 1606-1609.
27.	Wang Y, Ninaber DK, Faiz A, et al. Acute cigarette smoke exposure leads to higher viral infection in human bronchial epithelial cultures by altering interferon, glycolysis and GDF15-related pathways. Respir Res, 2023, 24(1): 207.
28.	Liu P, Gao H, Wang Y, et al. LncRNA H19 contributes to smoke-related chronic obstructive pulmonary disease by targeting miR-181/PDCD4 axis. COPD, 2023, 20(1): 119-125.
29.	Golpe R, Blanco-Cid N, Dacal-Rivas D, et al. Incidence and profile of severe exacerbations of chronic obstructive pulmonary disease due to biomass smoke or tobacco. Ann Thorac Med, 2022, 17(4): 193-198.
30.	Xu Z, Li F, Xin Y, et al. Prognostic risk prediction model for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD): a systematic review and meta-analysis. Respir Res, 2024, 25(1): 410.
31.	付玉芬, 牟婷, 何翔, 等. 慢性阻塞性肺疾病频繁急性加重的危险因素分析和预测模型构建. 中国医学科学院学报, 2024, 46(4): 519-527.
32.	Francis NA, Gillespie D, White P, et al. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT. Health Technol Assess, 2020, 24(15): 1-108.
33.	胡小燕, 徐镶怀, 郑晓, 等. 血清内皮细胞特异性分子 1 与降钙素原联合检测在慢性阻塞性肺疾病急性加重细菌感染中的临床意义. 海军军医大学学报, 2023, 44(8): 989-993.
34.	刘丹, 范惠君, 武亚莉, 等. 不同通气方式对急性加重慢性阻塞性肺疾病患者呼吸道病毒分布及预后的影响. 中国病原生物学杂志, 2021, 16(7): 822-825.
35.	方晗语, 陈琳雯, 冯沁祺, 等. 基于 VOSviewer 软件的中医药治疗慢性阻塞性肺疾病急性加重期文献计量学分析. 中国中医基础医学杂志, 2022, 28(2): 243-246, 259.
36.	陈艳, 李晓梅. 老年 COPD 患者急性加重期并发呼吸衰竭危险因素及风险模型构建. 中国老年学杂志, 2022, 42(22): 5478-5480.
37.	Marriott E, Singanayagam A, El-Awaisi J. Inflammation as the nexus: exploring the link between acute myocardial infarction and chronic obstructive pulmonary disease. Front Cardiovasc Med, 2024, 11: 1362564.
38.	Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med, 2020, 41(3): 421-438.
39.	余群, 欧阳丽. 痰热清注射液对痰浊壅肺型慢性阻塞性肺疾病急性加重期患者肺血管阻力和氧化应激指标的影响. 中国中医基础医学杂志, 2019, 25(10): 1380-1382, 1403.
40.	Yu S, Zhang H, Wan L, et al. The association between the respiratory tract microbiome and clinical outcomes in patients with COPD. Microbiol Res, 2023, 266: 127244.
41.	Wang Z, Maschera B, Lea S, et al. Airway host-microbiome interactions in chronic obstructive pulmonary disease. Respir Res, 2019, 20(1): 113.

1. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med, 2017, 5(9): 691-706.
2. Han W, Wang M, Xie Y, et al. Prevalence of pulmonary embolism and deep venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 732855.
3. Fang H, Zhang H, Wang Z, et al. Systemic immune-inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal, 2020, 34(1): e23016.
4. Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J, 2018, 52(5): 1801261.
5. 尹美玲, 孙晓媛, 岳利峰, 等. 基于文献计量学的国内外睡眠障碍研究现状与热点分析. 世界科学技术-中医药现代化, 2022, 24(1): 436-445.
6. Yao L, Hui L, Yang Z, et al. Freshwater microplastics pollution: detecting and visualizing emerging trends based on Citespace II. Chemosphere, 2020, 245: 125627.
7. 冯贞贞, 何雯青, 谢洋, 等. 慢性阻塞性肺疾病急性加重期证候疗效评价量表初步研制. 中国中西医结合杂志, 2023, 43(5): 564-571.
8. 何雯青, 冯贞贞, 春柳, 等. 慢性阻塞性肺疾病急性加重期证候疗效评价要素研究——基于文献研究结合专家咨询. 中医杂志, 2022, 63(5): 481-487.
9. 王至婉, 李羚, 李建生, 等. 基于贝叶斯网络的慢性阻塞性肺疾病急性加重期证候与症状间的关联模式. 中华中医药杂志, 2019, 34(9): 3964-3969.
10. 王露, 张海龙, 张东, 等. 中药治疗慢性阻塞性肺疾病急性加重系统评价/Meta 分析的质量评价. 中国老年学杂志, 2021, 41(14): 2968-2972.
11. 谢洋, 王佳佳, 李宣霖, 等. 针刺治疗慢性阻塞性肺疾病急性加重期的临床研究文献分析. 中国老年学杂志, 2019, 39(13): 3151-3154.
12. 王明航, 毕丽婵, 赵欢欢, 等. 慢性阻塞性肺疾病急性加重再入院影响因素. 中国老年学杂志, 2022, 42(13): 3354-3356.
13. 王明航, 陈学昂, 李晓俊, 等. 基于临床研究数据的慢性阻塞性肺疾病急性加重风险因素的筛选. 中华中医药杂志, 2019, 34(10): 4839-4846.
14. Bhatt SP, Agusti A, Bafadhel M, et al. Phenotypes, etiotypes, and endotypes of exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2023, 208(10): 1026-1041.
15. Han MK, Tayob N, Murray S, et al. Predictors of chronic obstructive pulmonary disease exacerbation reduction in response to daily azithromycin therapy. Am J Respir Crit Care Med, 2014, 189(12): 1503-1508.
16. Bhatt SP, Connett JE, Voelker H, et al. β-Blockers for the prevention of acute exacerbations of chronic obstructive pulmonary disease (βLOCK COPD): a randomised controlled study protocol. BMJ Open, 2016, 6(6): e012292.
17. Singh D, Criner GJ, Dransfield MT, et al. Informing the pathway of COPD treatment (IMPACT) trial: fibrinogen levels predict risk of moderate or severe exacerbations. Respir Res, 2021, 22(1): 130.
18. Han MK, Quibrera PM, Carretta EE, et al. Frequency of exacerbations in patients with chronic obstructive pulmonary disease: an analysis of the SPIROMICS cohort. Lancet Respir Med, 2017, 5(8): 619-626.
19. Leitao Filho FS, Mattman A, Schellenberg R, et al. Serum IgG levels and risk of COPD hospitalization a pooled meta-analysis. Chest, 2020, 158(4): 1420-1430.
20. Crisan L, Wong N, Sin DD, et al. Karma of cardiovascular disease risk factors for prevention and management of major cardiovascular events in the context of acute exacerbations of chronic obstructive pulmonary disease. Front Cardiovasc Med, 2019, 6: 79.
21. Kunisaki KM, Dransfield MT, Anderson JA, et al. Exacerbations of chronic obstructive pulmonary disease and cardiac events. a post hoc cohort analysis from the SUMMIT randomized clinical trial. Am J Respir Crit Care Med, 2018, 198(1): 51-57.
22. Dransfield MT, Criner GJ, Halpin D, et al. Time-dependent risk of cardiovascular events following an exacerbation in patients with chronic obstructive pulmonary disease: post hoc analysis from the IMPACT trial. J Am Heart Assoc, 2022, 11(18): e24350.
23. Agusti A, Celli BR, Criner GJ, et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. Respirology, 2023, 28(4): 316-338.
24. Du X, Chen Y, Zhang R, et al. Effects of Qingjin Huatan decoction on pulmonary function and inflammatory mediators in acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Front Pharmacol, 2024, 15: 1466677.
25. 宋卫珍, 董凌云. 噻托溴铵吸入剂联合布地奈德福莫特罗治疗对老年急性加重期 COPD 患者肺功能及对 HMGB1、Copeptin 的影响. 中国老年学杂志, 2020, 40(9): 1847-1851.
26. 何淑霞, 俞峭拔, 孙小丽, 等. 硫酸沙丁胺醇联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期患者的临床研究. 中国临床药理学杂志, 2020, 36(12): 1606-1609.
27. Wang Y, Ninaber DK, Faiz A, et al. Acute cigarette smoke exposure leads to higher viral infection in human bronchial epithelial cultures by altering interferon, glycolysis and GDF15-related pathways. Respir Res, 2023, 24(1): 207.
28. Liu P, Gao H, Wang Y, et al. LncRNA H19 contributes to smoke-related chronic obstructive pulmonary disease by targeting miR-181/PDCD4 axis. COPD, 2023, 20(1): 119-125.
29. Golpe R, Blanco-Cid N, Dacal-Rivas D, et al. Incidence and profile of severe exacerbations of chronic obstructive pulmonary disease due to biomass smoke or tobacco. Ann Thorac Med, 2022, 17(4): 193-198.
30. Xu Z, Li F, Xin Y, et al. Prognostic risk prediction model for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD): a systematic review and meta-analysis. Respir Res, 2024, 25(1): 410.
31. 付玉芬, 牟婷, 何翔, 等. 慢性阻塞性肺疾病频繁急性加重的危险因素分析和预测模型构建. 中国医学科学院学报, 2024, 46(4): 519-527.
32. Francis NA, Gillespie D, White P, et al. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT. Health Technol Assess, 2020, 24(15): 1-108.
33. 胡小燕, 徐镶怀, 郑晓, 等. 血清内皮细胞特异性分子 1 与降钙素原联合检测在慢性阻塞性肺疾病急性加重细菌感染中的临床意义. 海军军医大学学报, 2023, 44(8): 989-993.
34. 刘丹, 范惠君, 武亚莉, 等. 不同通气方式对急性加重慢性阻塞性肺疾病患者呼吸道病毒分布及预后的影响. 中国病原生物学杂志, 2021, 16(7): 822-825.
35. 方晗语, 陈琳雯, 冯沁祺, 等. 基于 VOSviewer 软件的中医药治疗慢性阻塞性肺疾病急性加重期文献计量学分析. 中国中医基础医学杂志, 2022, 28(2): 243-246, 259.
36. 陈艳, 李晓梅. 老年 COPD 患者急性加重期并发呼吸衰竭危险因素及风险模型构建. 中国老年学杂志, 2022, 42(22): 5478-5480.
37. Marriott E, Singanayagam A, El-Awaisi J. Inflammation as the nexus: exploring the link between acute myocardial infarction and chronic obstructive pulmonary disease. Front Cardiovasc Med, 2024, 11: 1362564.
38. Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med, 2020, 41(3): 421-438.
39. 余群, 欧阳丽. 痰热清注射液对痰浊壅肺型慢性阻塞性肺疾病急性加重期患者肺血管阻力和氧化应激指标的影响. 中国中医基础医学杂志, 2019, 25(10): 1380-1382, 1403.
40. Yu S, Zhang H, Wan L, et al. The association between the respiratory tract microbiome and clinical outcomes in patients with COPD. Microbiol Res, 2023, 266: 127244.
41. Wang Z, Maschera B, Lea S, et al. Airway host-microbiome interactions in chronic obstructive pulmonary disease. Respir Res, 2019, 20(1): 113.

West China Medical Journal

Research status and hotspot analysis of acute exacerbation of chronic obstructive pulmonary disease based on bibliometrics

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