我们真的需要哮喘-慢性阻塞性肺疾病重叠综合征吗？
2016/08/22
摘要
哮喘和慢性阻塞性肺疾病（COPD）在同一个患者身上的关系通常称为混合型哮喘-COPD表型或重叠综合征（ACOS），这仍是一个有争议的问题。这主要是因为在ACOS的定义上仍然存在许多相互矛盾的方面，并且很难总结此综合征的特点。此外，我们认识到，哮喘，慢性阻塞性肺疾病（COPD），和ACOS并不是单一的疾病，而是由几个内型和表型组成的综合征，形成的一个疾病谱。“哮喘-慢性阻塞性肺病重叠综合征（ACOS）”这个涵盖性术语模糊了哮喘和COPD之间的界限，简化了治疗。然而，这个术语违背了我们必须制定更具针对性和个体化的治疗方法来治疗这些患者现代观念。因此我们认为，当新的表型和潜在的内型被发现时，ACOS这个术语必须被抛弃并最终被取代，一个新的气道疾病分类方式将产生。
（苏欣 审校）
J Allergy Clin Immunol. 2016 Jun 4. pii: S0091-6749(16)30368-2. doi: 10.1016/j.jaci.2016.04.028. [Epub ahead of print]
Do we really need asthma-chronic obstructive pulmonary disease overlap syndrome?
Abstract
The association of asthma and chronic obstructive pulmonary disease (COPD) in the same patient, which is designated as mixed asthma-COPD phenotype or overlap syndrome (ACOS), remains a controversial issue. This is primarily because many conflicting aspects in the definition of ACOS remain, and it is extremely difficult to summarize the distinctive features of this syndrome. Furthermore, we are realizing that asthma, COPD, and ACOS are not single diseases but rather syndromes consisting of several endotypes and phenotypes and, consequently, comprising a spectrum of diseases. The umbrella term ACOS blurs the lines between asthma and COPD and allows an approach that simplifies therapy. However, this approach contradicts the modern concept according to which we must move toward more targeted and personalized therapies to treat patients with these diseases. Therefore we argue that the term ACOS must be abandoned and ultimately replaced when new phenotypes and underlying endotypes are identified and a new taxonomy of airway diseases is generated.
Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
KEYWORDS:Asthma; asthma–chronic obstructive pulmonary disease overlap syndrome; chronic obstructive pulmonary disease; definition; prevalence
J Allergy Clin Immunol. 2016 Jun 4. pii: S0091-6749(16)30368-2. doi: 10.1016/j.jaci.2016.04.028. [Epub ahead of print]
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