OBJECTIVE: This study was conducted to investigate the variation of monocyte chemoattrant protein-1 (MCP-1) and tissue factor (TF) in elderly patients with acutely exacerbated chronic obstructive pulmonary disease (AECOPD) and their clinical significance. PATIENTS AND METHODS: Serum specimens were obtained from 49 AECOPD. Patients and 30 health controls, with mean age of 76.1 +/- 10.2 and 62.8 +/- 6.5 years. Patients in AECOPD group were further grouped into two subgroups, with high or normal procaletonin (PCT) levels. Plasma TE, MCP-1 and PCT were qualified by enzyme-linked immunosorbent assay (ELISA). RESULTS: TF and MCP-1 were found to be higher in AECOPD patients than in health people (p < 0.01), and TF was linearly and positively related to MCP-1. In the subgroups TF was significantly higher in patients with higher PCT than those with normal PCT (p < 0.05). CONCLUSIONS: In AECOPD patients blood cells are activated to hypercoagulation state, particularly when their PCT level is high. Extrinsic pathway activated by TE plays important role in development of the hypercoagulation state. Our results indicate that plasma TF level was positively correlated to the level of MCP-1. This suggests that monitoring of plasma TF and MCP1 levels in AECOPD patients could be a very useful way to prevent and cure blood hypercoagulability, cardiovascular and cerebrovascular thrombotic diseases.