Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common condition,which affects not only the quality of life of patients but also their prognosis.The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.Methods Twenty-three patients with AECOPD were divided into a treatment group (He/O2=70％/30％) and a control group (N2/O2=70％/30％).The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days.Vital signs,arterial blood gas levels,pulmonary function and the levels of serum myostatin (sMSTN) were measured and lung vibration imaging was performed.Results We found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points (P ＞0.05).There were also no significant differences in any of the parameters of pulmonary function between the two groups.However,after baseline correction,the increase rate of the forced expiratory volume in one second (FEV1),the forced vital capacity (FVC),and the maximum minute ventilation (MW) appeared to be significantly increased at some time points compared with the baseline (before treatment) in both groups (P ＜0.05).Although the values of quantitative lung distribution (QLD) for different regions and the levels of sMSTN were slightly different between the two groups,the repeated measures analysis of variance (ANOVA) revealed that there were no significant differences between the two groups or within any group (P ＞0.05).Conclusion Although the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD,the heliox treatment group did not have significant differences in arterial blood gases,lung function,lung vibration response imaging or the levels of sMSTN compared with the control group.(Chinese Clinical Trial Register Center ChiCTR-TRC-00000273)