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1、 材料来源Asthma-COPDoverlapsyndrome(ACOS.AdiagnosticchallengeNaUEWAATHOHYPARKANDWsuAAKANCYJJegpioyCaeConterUniesiyMedesnjb0MnbOiyeanDifsonofRinonayand0ficaltoeNedineDspatmertofMfedcheSnstngedialenerSugbunttenUhiesiySciooloflhdcpeScoulSoufMomsand:DifsonofjespieoedceDspstnentofMiefone5hgaUniesiyofMiejialS
2、cinceShgoJpanABSTRACTAeasereportijustatingthiseviewAalhmtcronletstricttePalmonarydletseaviableialogyCasefeportsfeatureofACOS,wereassociatedwithahigherprevRespirology(2016)21,410-418Mainteachinoints_,重境综合征是同时具有晕善和慢-ACOSisadis的(标大疫ini-tationcombinedLuziasthmal除了吸入激素和支气菅扩张药物外,8nCOPD,。|有2要明硝和排阿可遮免的危险因素,
3、Inadditionto-dbron-chodilatortherapyrtimportanttoidentifyandeliminatem0d崛ab】eIiskfact0rSSuChassm0kmgTherapidrateioninACOSpatienttrmig门外八根贾仪挂皇标。,ofasthmaandsmok者引言Asthmaandchronicobstructivepulmonarydisease_(COPD)aretwoofthemostcommonlyencounteredchroniclungdiseasesinclinics.“heyarecharacter-izedbych
4、ronicinflammationandairwayremodel-ling,buttheydifferinthe覆anemsofinflammation,thestructuresaffectedandtheprimeanatomicsiteatWhichpathologicalcChangesocCUFInesedlfferences_thestructuresaffectedandtheprimeanatomicsiteatWhichpathologicalchangesoccur3esedifferencesaremostapparentwhenyoungnon-smokerswith
5、asthmaandoldersmokerswithCOPDarecompared.HoweveritmaybeproblematictodifferentiateACOSinteepeienEiisiainAsthma(GINAandGlobalInitiativeforChronicObstructiveLungDisease(GOLD)providesaclinicaldeScnponofasthma-COPD_overlapSyndr0me:COSischaracterizedby腌赡-0yasS0clatedwIthCOPDACOSisthereforeidentifiedbythef
6、eaturesthatitshareswithbothasthmaandBDWThisdescriptionisintuitivebutdifficulttoapplytodailyclinicalpractice.PhenotypeofCOPD?PrevalenceofACOSAC0S5hasnotbeendefneddefinitively8andisknownbydifferentnamesincludingoverlapsyn-dromeofasthmaandCOPD,mixedasthma-COPDphenotypellasthmacombinedwithCOPD,coexist-e
7、nceofasthmaandCOPD&orCOPDwithasthmaticfeaturesHOWbeenthemostcom-ImonlyusedterITable1CriteriafortheDiagnostsoftheMixedOPD-AsthmaPhenooypeUsedintheStudyMajorcriteriaPositivepostcbronchodilatortestwithanincreaseofFEVi15%and400mmlFENO40ppbPeronalhistoryofashmaWMinorcriterioElcvatedI8EinbloodPersonalhito
8、ryofatopyPositivepostcbronchodilatortestwithanincrcaseofFEVi12%and200ml训aleas2山fferenCmeasuretmenGfFENO:ffactionalexhaledniticaddAdaptedfromSolerCataluiaetaL7DifferentcriteriadifferentoutcomeTable1TheprevalencsofACOSfomdiferentstudypopulstonsWithdiferetdiagnosticrteriStudyEfgbleag8DiagnostcorieriaPh
9、evalencsFromthepopulatonfpatietswithasthmaMisneseal201255yeaDorumentedphysiiamdiagnosedasthma+clisscal。28%symplomofchonicbronditsandorDLo仪ppbandPesonalhistoofasthme。MinoroierielwatedserumlgpersonalhisonfofalopyandpostBDFEViinerase12%and2200mLoverbaselne002fmore0CasionsBurdenofACOSDActhmascopoOvedapzyndroms,_o|34-44yeers45-54yesrs55-54years65-74years75-84yesrs65yearsa口一vMaannumbwroltsatmentpoflodsperpatint、AndersenH.HighhospitalburdeninoverlapsyndromeofasthmaandCOPD.Clin.RespirJ2013;7:342-6.
