哮喘-COPD重叠综合征的临床特征

Clinical features of asthmatic-chronic obstructive pulmonary disease overlap syndrome

目的探讨哮喘-COPD重叠综合征（asthma—COPD overlap syndrome，ACOS）的临床特征。方法根据2014年全球哮喘防治创议（the Global Initiative for Asthma，GINA）标准，回顾性分析2014年1月至2016年4月中国医科大学附属盛京医院呼吸科病房及门诊受试者中支气管哮喘（简称哮喘）患者566例。在入选的哮喘患者中，选取年龄≥40岁，符合纳入标准的ACOS患者65例，单纯哮喘组75例。人院开始1周内收集如下资料：一般临床特征、血清嗜酸粒细胞计数、血清总IgE、肺功能。结果ACOS组平均年龄（58．80±9．00）岁，单纯哮喘组平均年龄（55．10±9．40）岁，ACOS组年龄高于单纯哮喘组（t=2．46，P〈0．05）；ACOS组患者吸烟的比例高于哮喘组（55．4％VS29．3％，x^2=9．74，P〈0．01）；ACOS组患者血清总IgE较高[（481．60±784．80）U／mlvs（153．90±139．10）U／ml，t=3．05，P〈0．01]；ACOS组患者有较低的FEV1（t=6．65，P〈0．01），差异有统计学意义。结论本研究发现ACOS组患者年龄较大，大部分患者有长期吸烟史，血清总IgE明显升高。ACOS组患者FEV-明显降低，造成2组差异的主要因素是年龄、吸烟和气道重塑。

Objective This research aims to investigate the clinical features of asthmatic-COPD overlap syndrome （ACOS）. Methods According to the Global Initiative for Asthma （GINA） of 2014,566 asthma patients were retrospectively analyzed. These patients came from respiratory ward or outpatient of Shengjing Hospital affiliated to China Medical University, from January 2014 to April 2016. In these patients, 65 cases of ACOS patients and 75 cases of asthma patients whose ages were higher than 40 were selected to the research. General clinical characteristics, serum eosinophil count, serum IgE and lung function were collected within one week of hospital. Results The ACOS group was older [（58.80± 9.00） years vs （55.10±9.40） years, t = 2.46, P 〈0.05] and contained a higher percentage of current or ex- smokers （55.4 % vs 29.3 %, x^2= 9.74, P 〈0.01） than the asthma only group. Significantly lower FEV1 （ t =6.65, P 〈0.01） and higher IgE [-（481.60±784.80） U/ml vs （153.90±139.10） U/mi, t =3.05, P 〈0.01] were seen in the overlap group. Conclusions Our results showed that the overlap phenotype was older who have a higher lifetime smoking intensity, more atopy and generally worse lung function.