哮喘联盟

   摘要
   研究目的：以不同定义为基础,研究慢阻肺高危人群中哮喘慢阻肺重叠综合征(ACOS)的发生率和特征。
   研究方法：241名全科医生连续纳入年龄35岁及以上的烟草暴露人群，伴有至少一种呼吸道症状且既往未诊断为阻塞性肺部疾病。ACOS定义为慢性气道阻塞,即应用支气管舒张药后, FEV1/FVC 比值 < 0.70,同时伴有喘息，明显可逆性支气管舒张或可逆性和肺功能受损同时存在，即FEV1 < 80%pred。
   研究结果：本研究纳入3.875例（其中50%为女性，平均年龄为57岁），700例（18%）被诊断为慢阻肺.其中ACOS的发生率分别为27%（喘息），60%(支气管舒张可逆)，14%（支气管舒张可逆和FEV1 < 80%pred）。ACOS患者在吸入支气管舒张剂后FEV1/FVC比值明显低于单纯COPD患者（p=0.02）。自诉伴有喘息的ACOS患者（n=190）其FEV1 %pred值比单纯慢阻肺患者更低（66% vs. 73%; p<0.0001），而当采用另外两种定义时，ACOS和单纯慢阻肺患者的FEV1 %pred值无显著差异，无论采用何种ACOS定义，在终生烟草暴露人群中，ACOS和单纯慢阻肺患者无明显差异。
   研究结论：在新诊断为慢阻肺的患者中，ACOS的发生率不同很大程度上依赖于所采用的诊断标准。因此更深入的研究ACOS是必要的，尤其是诊断标准需要达成一致至关重要。

 

（南方医科大学南方医院 王燕红 赵海金 ）
2015,ERS Meeting


 

Prevalence and characteristics of the asthma-COPD overlap syndrome - or the asthma-like COPD phenotype - in a COPD high risk population
 

Camilla Boslev Bårnes¹, Peter Kjeldgaard¹, Mia Nielsen¹, Charlotte Suppli Ulrik¹,²
¹Pulmonary Medicine, Hvidovre Hospital, Hvidovre, Denmark; ²Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
2015,ERS Meeting
PA5069 http://abstract.ersnet.org/my-abstract-book-2015/


Abstract
Objective: To investigate prevalence and characteristics of ACOS, based on different definitions, in a cohort of adults at high risk of COPD.
Method: General practitioners (n=241) consecutively recruited subjects ≥ 35 years old, with tobacco exposure, at least one respiratory symptom, and no previous diagnosis of obstructive lung disease. ACOS was defined as chronic airflow obstruction, i.e. post-bronchodilator FEV1/FVC ratio < 0.70, combined with either wheeze, significant bronchodilator [BD] reversibility, or both reversibility and lung function impairment, i.e. FEV1 < 80%pred.
Results: Of the 3.875 (50% females, mean age 57 years) subjects included in the study, 700 (18%) were diagnosed with COPD. The prevalence of ACOS among patients with COPD was 27% (wheeze), 16% (BD reversibility), and 14% (BD reversibility and FEV1 < 80%pred), respectively (p<0.001). ACOS patients had significant lower post-BD FEV1/FVC ratio compared to COPD only patients (p=0.02). ACOS patients with self-reported wheeze (n=190) had lower FEV1 %pred compared to COPD only patients (66% vs. 73%; p<0.0001), whereas no difference in level of FEV1 %pred was found between ACOS and COPD only patients when the two other definitions were applied. Irrespective of the ACOS-definition, no significant difference in life-time tobacco exposure was found between ACOS and COPD only patients.
Conclusion: In subjects with a new diagnosis of COPD, the prevalence of ACOS differs substantially depending on the applied diagnostic criteria. Further research into ACOS is needed, especially it seems of utmost importance to reach consensus on diagnostic criteria