哮喘联盟

   摘要
   背景：哮喘与慢性阻塞性肺病（COPD）的重叠是一个很重要的临床现象。然而，哮喘-慢性阻塞性肺病重叠综合症（ACOS）的患病率并不明确。
   目的：调查有吸烟史的哮喘患者的ACOS患病率，并评估该患者群体中ACOS的预测因素。
   方法：我们调查了190例初级护理哮喘患者，这些患者以前未被诊断为COPD，但是均有当前或过往吸烟史，且有至少10包-年的吸烟史。所有患者在服用常规哮喘药的同时进行了肺活量测定。如果使用支气管扩张剂后，1s用力呼气容积与用力肺活量的比值<0.70，则被认为患有ACOS。
   结果：52例（占27.4%）患者患有ACOS。年龄60岁以上和吸烟史>20包-年是ACOS最好的预测因素。如果这两个条件都得到满足，患ACOS的机率是这两个条件都不满足的6.08 (95%CI 2.11-17.49)倍。
   结论：以前未被诊断为COPD但有明确吸烟史的初级护理哮喘患者，其ACOS的患病率较高。在这个人群中，年龄超过60岁和吸烟史超过20包-年是ACOS的最佳预测因素。

 

（苏欣 审校）
NPJ Prim Care Respir Med. 2015 Jul 16;25:15047. doi: 10.1038/npjpcrm.2015.47.

 

Prevalence of asthma-COPD overlap syndrome among primary care asthmatics with a smoking history: a cross-sectional study.
 

Kiljander T1, Helin T2, Venho K3, Jaakkola A4, Lehtimäki L5.
 

Abstract
BACKGROUND:The overlap between asthma and chronic obstructive pulmonary disease (COPD) is an important clinical phenomenon. However, the prevalence of asthma-COPD overlap syndrome (ACOS) is not known.
AIMS:To investigate the prevalence of ACOS among asthmatic patients with a smoking history, and evaluate the factors predicting ACOS in this patient group.
METHODS:We investigated 190 primary care asthma patients with no previous diagnosis of COPD, but who were either current or ex-smokers, with a smoking history of at least 10 pack-years. Spirometry was performed on all the patients while they were taking their normal asthma medication. Patients were considered to have ACOS if their post bronchodilator forced expiratory volume in 1 s/forced vital capacity was <0.70.
RESULTS:Fifty-two (27.4%) of the patients were found to have ACOS. Age ⩾60 years and smoking for ⩾20 pack-years were the best predictors of ACOS. If both of these criteria were met, the odds ratio (95% confidence interval) for ACOS was 6.08 (2.11-17.49), compared with the situation where neither of these criteria were fulfilled.
CONCLUSIONS:There is a high prevalence of ACOS among primary health care asthmatics with a positive smoking history but no previous diagnosis of COPD. In this population, age over 60 years and a smoking history of more than 20 pack-years were the best predictors of ACOS.
 

NPJ Prim Care Respir Med. 2015 Jul 16;25:15047. doi: 10.1038/npjpcrm.2015.47.