慢性阻塞性肺疾病和哮喘重叠综合征临床特征研究

Studies on the characteristics of patients with overlap syndrome of chronic obstructive pulmonary disease and asthma

【目的】探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)与COPD和支气管哮喘重叠综合征的患者不同的临床特征。【方法】39例单纯COPD患者与15例COPD和支气管哮喘重叠综合征的患者,进行肺功能测试、动脉血气分析、血清免疫球蛋白E、外周血嗜酸性粒细胞计数检查。在给予吸入皮质激素(inhaled cocorticosteroid,ICS)治疗后进行肺功能检查及痰液中炎症细胞的分析。【结果】ICS治疗后,COPD和支气管哮喘重叠综合征组患者第1秒钟用力呼气容积(forcedexpiratory volume in one second,FEV1)提高显著高于单纯COPD组,痰液嗜酸性粒细胞计数显著高于单纯COPD组,且FEV1的提高和痰液嗜酸性粒细胞计数的增多具有显著相关性。【结论】COPD和支气管哮喘重叠综合征患者有其不同的临床特征,ICS对这类患者的治疗有效,痰液嗜酸性粒细胞增多很可能是对于ICS治疗反应的良好预测因素,但还需要进一步的研究去证实。

[Objective]To explore the difference of the clinical characteristics in patients with overlap syndrome of chronic obstructive pulmonary disease（COPD） and asthma. [ Methods ] Thirty-nine patients with COPD and fifteen patients with overlap syndrome of COPD and asthma were underwent pulmonary function tests,arterial blood gas analysis,serum immunoglobulin E and inflammatory cells in peripheral blood. After inhaling cortieosteroid （ICS）,analyze the inflammatory cells in induced sputum and pulmonary function tests were determined and analyzed.The clinical features of COPD patients with asthmatic symptoms were compared with those of COPD patients without asthmatic symptoms. [ Results ] The increases of FEV 1 in response to treatment with ICS were significantly higher in the C OPD with asthma group. The peripheral eosinophil counts and sputum eosinophil counts were also significantly higher. A significant correlation was observed between the increases in forced expiratory volume in one second（FEV1） in response to treatment with ICS and sputum eosinophil counts. [Conclusions] COPD patients with asthmatic symptoms have some clinical features. ICS should be considered earlier as a potential treatment in such patients. High sputum eosinophil counts may therefore be a good predictor of response to ICS. Further studies to confirm these findings are warranted.