哮喘慢阻肺重叠综合征患者的临床特征
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摘要
目的分析哮喘慢阻肺重叠综合征(ACOS)患者临床特征。方法收集我院呼吸内科ACOS、哮喘和慢性阻塞性肺疾病(COPD)住院患者各100例作为研究对象,对比3组患者一般资料、实验室检查指标及呼吸功能指标的差异。结果 (1)哮喘组、ACOS组和COPD组患者的年龄依次升高(P <0.05);哮喘组、ACOS组和COPD组患者的外周血嗜酸性粒细胞百分比依次降低(P <0.05)。(2)ACOS组的FEV1/FVC%与FEV1%pred低于哮喘组(P <0.05),小气道功能障碍的比例及RV/TLC%高于哮喘组(P <0.05),FeNO低于哮喘组(P <0.05),但高于COPD(P <0.05)。(3)ACOS患者的FEV1变异率高于慢阻肺组(P <0.05)。结论相对于哮喘患者,ACOS患者年龄偏大,肺通气功能较低,小气道功能障碍更显著,残气量更加显著,嗜酸性粒细胞气道炎症反应较轻;与COPD患者相比,上述指标呈反向变化。
Objective To analyze the clinical characteristics of patients with ACOS. Methods Three undred hospitalized patients with ACOS,asthma and chronic obstructive pulmonary disease were enrolled in this study,with 100 cases of each kind disease. The general information indicators,laboratory test indicators and respiratory function indexs were collected and compared. Results(1)The age of patients in asthma group,ACOS group and COPD group was significantly increased(P < 0.05).(2)The percentage of eosinophils in peripheral blood was decreased(P < 0.05).(3)The FEV1/FVC% and FEV1% pred were lower in ACOS group than those in the asthma group(P < 0.05,respectively). The proportion of small airway dysfunction in ACOS group was higher than that in asthmatic group(P < 0.05). The RV/TLC% in ACOS group was higher than that in the asthma group(P < 0.05). The FeNO in ACOS group was lower than that in the asthma group(P < 0.05),but higher than that in COPD group(P < 0.05).(4)After bronchial diastolic test,the FEV1 mutation rate in patients with ACOS was higher than that in COPD group(P < 0.05). Conclusion Compared with asthma,ACOS patients were older,the pulmonary ventilation function was lower,the airway dysfunction was more significant,the residual volume was more significant,the lung diffuse function was lower and acidic granulocyte airway inflammation was milder. But compared with patients with COPD,the above-mentioned indexes of ACOS patients were on the contrary.
Objective To analyze the clinical characteristics of patients with ACOS. Methods Three undred hospitalized patients with ACOS,asthma and chronic obstructive pulmonary disease were enrolled in this study,with 100 cases of each kind disease. The general information indicators,laboratory test indicators and respiratory function indexs were collected and compared. Results(1)The age of patients in asthma group,ACOS group and COPD group was significantly increased(P < 0.05).(2)The percentage of eosinophils in peripheral blood was decreased(P < 0.05).(3)The FEV1/FVC% and FEV1% pred were lower in ACOS group than those in the asthma group(P < 0.05,respectively). The proportion of small airway dysfunction in ACOS group was higher than that in asthmatic group(P < 0.05). The RV/TLC% in ACOS group was higher than that in the asthma group(P < 0.05). The FeNO in ACOS group was lower than that in the asthma group(P < 0.05),but higher than that in COPD group(P < 0.05).(4)After bronchial diastolic test,the FEV1 mutation rate in patients with ACOS was higher than that in COPD group(P < 0.05). Conclusion Compared with asthma,ACOS patients were older,the pulmonary ventilation function was lower,the airway dysfunction was more significant,the residual volume was more significant,the lung diffuse function was lower and acidic granulocyte airway inflammation was milder. But compared with patients with COPD,the above-mentioned indexes of ACOS patients were on the contrary.
引文
[1] SHIMODA T,OBASE Y,NAGASAKA Y,et al. Lung sound analysis can be an index of the control of bronchial asthma[J].Allergol Int,2017,66(1):64-69.
[2] RILEY C M,SCIURBA F C. Diagnosis and outpatient management of chronic obstructive pulmonary disease:A review[J].JAMA,2019,321(8):786-797.
[3]孙永昌.哮喘-慢阻肺重叠综合征指南解读[J].中国呼吸与危重监护杂志,2014,13(4):325-329.
[4] DESCHILDRE A,PIN I,EL A K,et al. Asthma control assessment in a pediatric population:Comparison between GINA/NAEPP guidelines,Childhood Asthma Control Test(C-ACT),and physician′s rating[J]. Allergy,2014,69(6):784-790.
[5] HILMARSEN C W,WILKE S,ENGAN H,et al. Impact of symptoms of anxiety and depression on COPD Assessment Test scores[J]. Eur Respir J,2014,43(3):898-900.
[6]魏兵,周玉涛,陈玉,等.不同程度慢性阻塞性肺疾病患者支气管舒张试验前后肺功能各参数改善的比较[J].医学综述,2017,23(6):1219-1223.
[7] NAKAWAH M O,HAWKINS C,BARBANDI F. Asthma,chronic obstructive pulmonary disease(COPD),and the overlap syndrome[J]. J Am Board Fam Med,2013,26(4):470-477.
[8] HARADA T,YAMASAKI A,FUKUSHIMA T,et al. Causes of death in patients with asthma and asthma-chronic obstructive pulmonary disease overlap syndrome[J]. Int J Chron Obstruct Pulmon Dis,2015,10(1):595-602.
[9]李鸿茹,林丹,陈愉生,等.哮喘慢阻肺重叠综合征与单纯慢性阻塞性肺疾病的病例对照研究[J].中国呼吸与危重监护杂志,2015,14(4):332-336.
[10] KRUG N,HOHLFELD JM,BUHL R,et al. Blood eosinophils predict therapeutic effects of a GATA3-specific DNAzyme in asthma patients[J]. J Allergy Clin Immunol,2017,140(2):625-628.
[11]何桂媛,李文新,王莉,等. miR-146在支气管哮喘发生发展中的研究进展[J].实用医学杂志,2018,34(10):1737-1739.
[12] IWAMOTO H,GAO J,KOSKELA J,et al. Differences in plasma and sputum biomarkers between COPD and COPD-asthma overlap[J]. Eur Respir J,2014,43(2):421-429.
[13] FU J J,MCDONALD V M,GIBSON P G,et al. Systemic inflammation in older adults with asthma-COPD overlap syndrome[J]. Allergy Asthma Immunol Res,2014,6(4):316-324.
[14]韩国敬,许菡苡,胡红,等.哮喘-慢阻肺重叠综合征、哮喘及慢阻肺患者的肺功能及临床特征比较[J].解放军医学院学报,2016,37(11):1122-1125.
[15]韩美荣,陈燕,李剑平.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床意义[J].临床肺科杂志,2016,21(5):934-937.
[16] SOLER-CATALU?A J J,COSíO B,IZQUIERDO J L,et al.Consensus document on the overlap phenotype COPD–asthma in COPD[J]. Arch Bronconeumol,2012,48(9):331-337.
[17]熊小明,童国强,付云杰,等.支气管哮喘-慢性阻塞性肺疾病重叠综合征患者呼出气冷凝液和血清8-isoPG、MPO、LTB4、IL-6的测定及临床意义[J].实用医学杂志,2018,34(4):649-652.
[2] RILEY C M,SCIURBA F C. Diagnosis and outpatient management of chronic obstructive pulmonary disease:A review[J].JAMA,2019,321(8):786-797.
[3]孙永昌.哮喘-慢阻肺重叠综合征指南解读[J].中国呼吸与危重监护杂志,2014,13(4):325-329.
[4] DESCHILDRE A,PIN I,EL A K,et al. Asthma control assessment in a pediatric population:Comparison between GINA/NAEPP guidelines,Childhood Asthma Control Test(C-ACT),and physician′s rating[J]. Allergy,2014,69(6):784-790.
[5] HILMARSEN C W,WILKE S,ENGAN H,et al. Impact of symptoms of anxiety and depression on COPD Assessment Test scores[J]. Eur Respir J,2014,43(3):898-900.
[6]魏兵,周玉涛,陈玉,等.不同程度慢性阻塞性肺疾病患者支气管舒张试验前后肺功能各参数改善的比较[J].医学综述,2017,23(6):1219-1223.
[7] NAKAWAH M O,HAWKINS C,BARBANDI F. Asthma,chronic obstructive pulmonary disease(COPD),and the overlap syndrome[J]. J Am Board Fam Med,2013,26(4):470-477.
[8] HARADA T,YAMASAKI A,FUKUSHIMA T,et al. Causes of death in patients with asthma and asthma-chronic obstructive pulmonary disease overlap syndrome[J]. Int J Chron Obstruct Pulmon Dis,2015,10(1):595-602.
[9]李鸿茹,林丹,陈愉生,等.哮喘慢阻肺重叠综合征与单纯慢性阻塞性肺疾病的病例对照研究[J].中国呼吸与危重监护杂志,2015,14(4):332-336.
[10] KRUG N,HOHLFELD JM,BUHL R,et al. Blood eosinophils predict therapeutic effects of a GATA3-specific DNAzyme in asthma patients[J]. J Allergy Clin Immunol,2017,140(2):625-628.
[11]何桂媛,李文新,王莉,等. miR-146在支气管哮喘发生发展中的研究进展[J].实用医学杂志,2018,34(10):1737-1739.
[12] IWAMOTO H,GAO J,KOSKELA J,et al. Differences in plasma and sputum biomarkers between COPD and COPD-asthma overlap[J]. Eur Respir J,2014,43(2):421-429.
[13] FU J J,MCDONALD V M,GIBSON P G,et al. Systemic inflammation in older adults with asthma-COPD overlap syndrome[J]. Allergy Asthma Immunol Res,2014,6(4):316-324.
[14]韩国敬,许菡苡,胡红,等.哮喘-慢阻肺重叠综合征、哮喘及慢阻肺患者的肺功能及临床特征比较[J].解放军医学院学报,2016,37(11):1122-1125.
[15]韩美荣,陈燕,李剑平.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床意义[J].临床肺科杂志,2016,21(5):934-937.
[16] SOLER-CATALU?A J J,COSíO B,IZQUIERDO J L,et al.Consensus document on the overlap phenotype COPD–asthma in COPD[J]. Arch Bronconeumol,2012,48(9):331-337.
[17]熊小明,童国强,付云杰,等.支气管哮喘-慢性阻塞性肺疾病重叠综合征患者呼出气冷凝液和血清8-isoPG、MPO、LTB4、IL-6的测定及临床意义[J].实用医学杂志,2018,34(4):649-652.
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