肺功能在支气管哮喘、COPD及哮喘-COPD重叠中的差异性分析

Differences in lung function in patients with bronchial asthma,chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap syndrome

目的分析支气管哮喘(哮喘)、慢性阻塞性肺疾病(COPD)及哮喘-COPD重叠综合征(ACOS)患者肺功能的差异性。方法回顾性研究。以首都医科大学附属北京同仁医院2016年10月至2018年11月收治哮喘213例、COPD 206例及ACOS 72例患者作为研究对象。分析3组之间肺通气功能、容量功能、弥散功能、气道阻力(R_(aw))及气道传导率(G_(aw))等变化。结果ACOS组FEV1%pred、FEV1/FVC、FVC%pred及MMEF%pred均显著低于哮喘组和COPD组,COPD组FEV1也均显著低于哮喘组(P<0.05)。ACOS组R_(aw)显著高于哮喘组和COPD组,(3.94±1.45)cmH_(2)O·L^(-1)·s^(-1),(2.71±0.62)cmH_(2)O·L^(-1)·s^(-1),(3.72±1.15)cmH_(2)O·L^(-1)·s^(-1)(P<0.05),G_(aw)显著低于哮喘组和COPD组,(0.32±0.14)cmH_(2)O·L^(-1)·s^(-1)(0.53±0.17)cmH_(2)O·L^(-1)·s^(-1)(0.35±0.15)cmH_(2)O·L^(-1)·s^(-1)(P<0.05)。结论哮喘、COPD和ACOS的临床肺功能相关指标具有显著差异性,结合气道阻力检测更利于三者鉴别诊断。

Objective To analyze the differences in pulmonary function of patients with bronchial asthma(BA),chronic obstructive pulmonary disease(COPD)and asthma complicated COPD overlap syndrome(ACOS).Methods This study was a retrospective cohort study,including BA patients 213 cases,206 COPD patients 206 cases and ACOS patients 72 cases from October 2016 to November 2018 admitted in Beijing Tongren Hospital of Capital Medical University.The lung ventilation function,volume function,diffusion function,airway resistance(R_(aw))and airway conductivity(G_(aw))were analyzed among three groups.Results FEV1,FEV1%pre,FEV1/FVC,FVC and MMEF%pred were significantly lower in ACOS group than in BA group and COPD group.Also,these indexes were significant lower in COPD group than in BA group(P<0.05);R_(aw)in ACOS group was significantly higher than that in BA group and COPD group FEV1%pred,FEV1/FVC,FVC%pred and MMEF%pred,(3.94±1.45)cmH_(2)O·L^(-1)·s^(-1),(2.71±0.62)cmH_(2)O·L^(-1)·s^(-1),(3.72±1.15)cmH_(2)O·L^(-1)·s^(-1).G_(aw)in ACOS group was significantly lower than that in BA group and COPD group,(0.32±0.14)cmH_(2)O·L^(-1)·s^(-1),(0.53±0.17)cmH_(2)O·L^(-1)·s^(-1),(0.35±0.15)cmH_(2)O·L^(-1)·s^(-1)(P<0.05).Conclusions The clinical pulmonary function indexes in BA,COPD and ACOS are quite different,and their combination with airway resistance detection is more conducive to the differential diagnosis of the three diseases.