Objective: To investigate the efficacy and safety of riociguat in patients with chronic obstructive pulmonary disease (COPD) complicated by pulmonary arterial hypertension (PAH). Methods: A total of 98 patients with COPD and PAH admitted to Zhongxiang People’s Hospital from January 2023 to December 2024 were selected and randomly divided into a control group and an observation group using a random number table method, with 49 patients in each group. The control group received conventional treatment, while the observation group received riociguat in addition to the conventional treatment. Clinical efficacy, pulmonary function indicators, pulmonary artery pressure indicators, blood gas indicators, and 6-minute walking distance were compared between the two groups, and adverse reactions during treatment were recorded. Results: After treatment, the total effective rate in the observation group was 93.88%, higher than that in the control group (79.59%). The pulmonary function indicators, pulmonary artery pressure indicators, blood gas indicators, and 6-minute walking distance in the observation group were superior to those in the control group, with statistically significant differences (p < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (p > 0.05). Conclusion: Riociguat treatment can improve pulmonary function, pulmonary artery pressure, and blood gas status in patients with COPD complicated by PAH, enhance exercise tolerance and clinical efficacy, and is safe without increasing the risk of adverse reactions.
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