Objective To analyze the risk factors for lung injury and pulmonary arterial hypertension in patients with chronic obstructive pulmonary disease （COPD）， and the predictive value of serum SDF-1 and sRAGE for lung injury and pulmonary arterial hypertension. Methods A total of 200 patients with COPD admitted to our hospital from January 2021 to January 2023 were selected as research objects， 23 of whom occurred lung injury and the rest 177 had no lung injury， and 31 developed pulmonary hypertension and the remaining 169 had no pulmonary hypertension. The predictive value of serum SDF-1 and sRAGE for pulmonary injury and pulmonary hypertension was analyzed. Results Multi-factor logistic regression analysis showed that D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， pulmonary hypertension， arterial blood oxygen partial pressure， FVC and FEV1 were the main factors affecting lung injury in patients with COPD. D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， arterial partial oxygen pressure， FVC， FEV1 and CT angiographic pulmonary artery volume were the main factors affecting the occurrence of pulmonary hypertension in those patients （P < 0.05）. Serum SDF-1 and sRAGE were positively correlated with lung injury and pulmonary hypertension in patients with COPD （P < 0.05）. The sensitivity and accuracy of SDF-1 and sRAGE for predicting lung injury and pulmonary hypertension in patients with COPD were higher than those of SDF-1 and SRage alone （P < 0.05）. Conclusions Pulmonary injury in patients with COPD is associated with D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， pulmonary hypertension， arterial blood oxygen partial pressure， FVC， FEV1. The occurrence of pulmonary hypertension is related to D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， arterial partial pressure of oxygen， FVC， FEV1 and CT angiography of pulmonary artery volume. Combined detection of SDF-1 and sRAGE has a higher predictive value for lung injury and pulmonary hypertension.