哮喘-慢阻肺重叠综合征患者240例临床特征分析

发布时间：2019-02-18 11:53

【摘要】：目的探讨哮喘-慢阻肺重叠综合征患者的临床特征。方法采用基于医疗信息数据库的回顾性队列研究方法,调取接受治疗随访1年以上,固定气流受限患者信息,按照哮喘、慢阻肺,以及新版2014年哮喘-慢阻肺重叠综合征(asthma and chronic obstructive pulmonary disease overlap syndrome,ACOS)联合指南的标准形成三组患者队列,统计队列中ACOS患者的比例、年龄分布;分析比较患者末次随访的气道炎症细胞、肺功能及年化FEV1下降率等临床特征。结果 240例初诊特征符合研究标准的患者被纳入分析,按新指南标准分组发现ACOS患者比例为29.17%,以40岁以上年龄患者为主(88.57%),男性患者(61.40%)略多于女性患者,78.58%的患者支气管舒张后第1秒用力肺活量占预计值的比例(post FEV1%pre)在50%以上,其性别组成、中位年龄、肺功能、气道嗜酸性粒细胞炎症患者比例与哮喘患者和慢阻肺患者比较,差异有统计学意义(P0.05),具体数值介于哮喘患者和慢阻肺患者之间。未来风险评估提示虽然ACOS患者年化FEV1下降率与哮喘、慢阻肺患者差异无统计学意义(P0.05),但下降的绝对值最大;而且中、重度年化急性加重的发生率也与慢阻肺患者相似,显著高于哮喘患者(P0.01)。结论 ACOS患者的临床特征介于哮喘、慢阻肺之间,而其未来风险更接近于慢阻肺。
[Abstract]:Objective to investigate the clinical features of asthmatic-chronic obstructive pulmonary overlap syndrome. Methods A retrospective cohort study based on medical information database was used to collect the information of patients with airflow limitation who were followed up for more than one year according to asthma and chronic obstructive pulmonary disease (COPD). And the new 2014 guidelines for asthmatic / chronic obstructive pulmonary overlap syndrome (asthma and chronic obstructive pulmonary disease overlap syndrome,ACOS) combined to form a cohort of three groups of patients, counting the proportion and age distribution of ACOS patients in the cohort; The clinical features of airway inflammatory cells, pulmonary function and annual FEV1 were analyzed and compared. Results 240 patients who met the study criteria were included in the analysis. According to the new guidelines, the proportion of patients with ACOS was 29.17, mainly over 40 years old (88.57%). Male patients (61.40%) were slightly more than female patients, 78.58% of the patients had forced vital capacity (post FEV1%pre) over 50% of the predicted value in 1 second after bronchodiastole. The proportion of airway eosinophils in patients with airway eosinophils was significantly higher than that in asthma and COPD patients (P0.05). The specific values were between asthmatic patients and COPD patients. Future risk assessment showed that although there was no significant difference in the annual FEV1 decline rate between ACOS patients and asthma and COPD patients (P0.05), the absolute value of the decrease was the largest. The incidence of severe acute exacerbation was similar to that of chronic obstructive pulmonary disease, significantly higher than that of asthmatic patients (P0.01). Conclusion the clinical features of ACOS patients are between asthma and COPD, and the future risk is closer to that of COPD.
【作者单位】：第三军医大学新桥医院全军呼吸内科研究所全军呼吸病研究重点实验室;
【基金】：“十二五”国家科技支撑计划(2012BAI05B02,2014BAI08B05)~~
【分类号】：R562.25;R563.9

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