Objective To investigate and compare the clinical characteristics of chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS).
Methods A case-control study was conducted in 139 patients with COPD who admitted between March 2013 and September 2013. The patients were divided into a COPD-only group and an ACOS group. Clinical data were collected and compared between two groups.
Results Of all 139 patients, 93 patients were diagnosed with COPD only (66.9%) and 46 patients were diagnosed with ACOS (33.1%). Compared with the COPD-only group, the ACOS group had a lower ratio of exposure to cigarette smoking (80.4% vs. 93.5%), but high possibility of a history of asthma (89.1% vs. 4.3%), allergies (60.9% vs. 9.6%) and airway hyperreactivity (80.4% vs. 6.5%) (P < 0.05). In clinical symptoms, the ACOS group had a higher ratio of breathless as the first complaint of symptom (26.1% vs. 8.6%) and dry and moist rales in lung by auscultation (67.4% vs. 31.2%) (P < 0.05). In laboratory examination, the ACOS group had increased levels of peripheral blood eosinophils and IgE than those of the COPD-only group (21.7% vs. 5.4%, 18.3% vs. 4.3%, P < 0.05). In treatment, the ACOS group was more likely to use systemic glucocorticoid (58.7% vs. 24.7%) and be treated with higher dosage of glucocorticoid (80 mg, P < 0.05).
Conclusions ACOS and COPD-only are two subtypes of COPD. Compared with COPD-only patients, ACOS patients might be more likely to be breathless and have dry and moist rales in clinical symptoms, more likely to have increased levels of peripheral blood eosinophils and IgE in blood test, and more inclined to receive systemic glucocorticoid treatment.
Citation：
LiHongru, LinDan, ChenYusheng, LinMing, YueWenxiang, XuNengluan, YuMeie, TuXunwei, LinXiaohong, YaoXiuqin. Case-control Study on Asthma-COPD Overlap Syndrome and Chronic Obstructive Pulmonary Disease. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(4): 332-336. doi: 10.7507/1671-6205.2015083
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- 3. Soler-Cataluña JJ, Cosío B, Izquierdo JL, et al.Consensus document on the overlap phenotype COPD-asthma in COPD.Arch Bronconeumol, 2012, 48:331-337.
- 4. 葛均波, 徐永健, 主编.内科学.北京:人民卫生出版社, 2013, 21-30.
- 5. Gibson PG, Simpson JL.The overlap syndrome of asthma and COPD:what are its features and how important is it? Thorax, 2009, 64:728-735.
- 6. Global strategy for asthma management and prevention 2014(revision). www.ginasthma.org.
- 7. Silva GE, Sherrill DL, Guerra S, et al.Asthma as a risk factor for COPD in a longitudinal study.Chest, 2004, 126:59-65.
- 8. 何薇, 宋康, 陈芳.肺功能在诊断支气管哮喘合并慢性阻塞性肺疾病中的应用.国际呼吸杂志, 2013, 33:1003-1005.
- 9. Vonk JM, Jongepier H, Panhuysen CI, et al.Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coefficient in patients with asthma after 26 years of follow up.Thorax, 2003, 58:322-327.
- 10. Miravitlles M, Soler-Cataluña JJ, Calle M, et al.A new approach to grading and treating COPD based on clinical phenotypes:summary of the Spanish COPD guidelines(GesEPOC).Prim Care Respir J, 2013, 22:117-121.
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