The clinical features of the overlap between COPD and asthma

被引：336
作者：
Hardin M. [1 ,2 ]
Silverman E.K. [1 ,2 ]
Barr R.G. [3 ]
Hansel N.N. [4 ]
Schroeder J.D. [5 ,18 ]
Make B.J. [5 ]
Crapo J.D. [5 ]
Hersh C.P. [1 ,2 ,8 ]
Curtis J. [6 ]
Kazerooni E. [6 ]
Hanania N. [7 ]
Alapat P. [7 ]
Bandi V. [7 ]
Guntupalli K. [7 ]
Guy E. [7 ]
Mallampalli A. [7 ]
Trinh C. [7 ,15 ]
Atik M. [7 ]
DeMeo D. [8 ]
Washko G. [8 ]
Jacobson F. [8 ]
Graham Barr R. [9 ]
Thomashow B. [9 ]
Austin J. [9 ]
Neil MacIntyre, Jr. [10 ]
Washington L. [10 ]
Page McAdams H. [10 ]
Rosiello R. [11 ]
Bresnahan T. [11 ]
McEvoy C. [12 ]
Tashjian J. [12 ]
Wise R. [13 ]
Hansel N. [4 ]
Brown R. [13 ]
Diette G. [13 ]
Casaburi R. [14 ]
Porszasz J. [14 ]
Fischer H. [14 ]
Budoff M. [14 ]
Sharafkhaneh A. [15 ]
Kamal H. [15 ]
Darvishi R. [15 ]
Niewoehner D. [16 ]
Allen T. [16 ]
Anderson Q. [16 ]
Rice K. [16 ]
Foreman M. [17 ]
Westney G. [17 ]
Berkowitz E. [17 ]
Bowler R. [18 ]
机构：
[1] Brigham and Women's Hospital, Harvard Medical School, Channing Laboratory, Boston, MA
[2] Brigham and Women's Hospital, Harvard Medical School, Division of Pulmonary and Critical Care Medicine, Boston, MA
[3] Columbia University, Department of Medicine, College of Physicians and Surgeons, New York, NY
[4] Johns Hopkins University, Department of Pulmonary and Critical Care Medicine, Baltimore, MD
[5] National Jewish Health, Division of Pulmonary Sciences and Critical Care Medicine, Denver, CO
[6] Arbor, VA
[7] Baylor College of Medicine, Houston, TX
[8] Brigham and Women's Hospital, Boston, MA
[9] Columbia University, New York, NY
[10] Duke University Medical Center, Durham, NC
[11] Fallon Clinic, Worcester, MA
[12] Health Partners Research Foundation, Minneapolis, MN
[13] Johns Hopkins University, Baltimore, MD
[14] Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Los Angeles, CA
[15] Michael E. DeBakey VAMC, Houston, TX
[16] Minneapolis, VA
[17] Morehouse School of Medicine, Atlanta, GA
[18] National Jewish Health, Denver, CO
[19] Temple University, Philadelphia, PA
[20] University of Alabama, Birmingham, AL
[21] University of California, San Diego, CA
[22] University of Iowa, Iowa City, IA
[23] University of Michigan, Ann Arbor, MI
[24] University of Minnesota, Minneapolis, MN
[25] University of Pittsburgh, Pittsburgh, PA
[26] University of Texas Health Science Center at San Antonio, San Antonio, TX
[27] LDS Hospital, Salt Lake City, UT
[28] Biological Repository, Johns Hopkins University, Baltimore, MD
[29] Data Coordinating Center and Biostatistics, National Jewish Health, Denver, CO
[30] Carla Wilson Epidemiology Core, University of Colorado School of Public Health, Denver, CO
来源：
Respiratory Research | / 12卷 / 1期
基金：
美国国家卫生研究院;
关键词：
Airway hyperresponsiveness; Asthma; Chronic obstructive pulmonary disease; Emphysema; Exacerbation; Gas-trapping;
D O I：
10.1186/1465-9921-12-127
中图分类号：
学科分类号：
摘要：
Background: The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods: We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results: 119 (13%) of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001) with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001). More African-Americans reported a history of asthma (33.6% vs 15.6%, p < 0.0001). Subjects with COPD and asthma demonstrated worse disease-related quality of life, were more likely to have had a severe COPD exacerbation in the past year, and were more likely to experience frequent exacerbations (OR 3.55 [2.19, 5.75], p < 0.0001). Subjects with COPD and asthma demonstrated greater gas-trapping on chest CT. There were no differences in spirometry or CT measurements of emphysema or airway wall thickness. Conclusion: Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration: ClinicalTrials.gov: NCT00608764. © 2011 Hardin et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 31 条
[1]  
Minino A.M., Xu J., Kochanek K.D., Deaths: Preliminary data for 2008, National Vital Statistics Reports, 59, 2, pp. 1-71, (2010)
[2]  
Mannino D.M., Homa D.M., Akinbami L.J., Ford E.S., Ress S.C., Chronic obstructive pulmonary disease surveillance - United States, 1971-2000, MMWR Surveill Summ, 51, pp. 1-16, (2002)
[3]  
Jemel A., Ward E., Hao Y., Thun M., Trends in the leading causes of death in the United States, 1970-2002, JAMA, 294, pp. 1255-1259, (2005)
[4]  
Global Strategy for the Diagnosis, Management and Prevention of COPD, (2010)
[5]  
Hersh C.P., Jacobsen F.L., Gill R., Silverman E.K., Computed tomography phenotypes in severe, early-onset chronic obstructive pulmonary disease, COPD, 4, pp. 331-337, (2007)
[6]  
Soriano J.B., Davis K.J., Coleman B., Visick G., Mannino D., Pride N.B., The proportional venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom, Chest, 124, pp. 474-481, (2003)
[7]  
Rijcken B., Schouten J.P., Xu X., Rosner B., Weiss S.T., Airway hyperresponsiveness to histamine associated with accelerated decline in FEV1, Am J Respir Crit Care Med, 151, 5, pp. 1377-1382, (1995)
[8]  
Tashkin D.P., Altose M.D., Connett J.E., Kanner R.E., Lee W.W., Wise R.A., Methacholine reactivity predicts changes in lung function over time in smokers with early chronic obstructive pulmonary disease. The lung health study research group, Am J Respir Crit Care Med, 153, 6, pp. 1802-1811, (1996)
[9]  
Lange P., Parner J., Vestbo J., Schnohr P., Jensen G., A 15-Year follow-up study of ventilatory function in adults with asthma, N Engl J Med, 339, 17, pp. 1194-1200, (1998)
[10]  
Silva G.E., Sherrill D.L., Guerra S., Barbee R.A., Asthma as a risk factor for COPD in a longitudinal study, Chest, 126, 1, pp. 59-65, (2004)
1234