Increased Risk of Exacerbation in Asthma Predominant Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

被引：4

作者：

Park, Jisoo ^{[1
]}

Kim, Eun-Kyung ^{[1
]}

Kim, Mi-Ae ^{[1
]}

Kim, Tae-Hyung ^{[2
]}

Chang, Jung Hyun ^{[3
]}

Ryu, Yon Ju ^{[3
]}

Lee, Sei Won ^{[4
]}

Oh, Yeon-Mok ^{[4
]}

Yong, Suk Joong ^{[5
]}

Choi, Won-Il ^{[6
]}

Yoo, Kwang Ha ^{[7
]}

Lee, Ji-Hyun ^{[1
]}

机构：

[1] CHA Univ, CHA Bundang Med Ctr, Dept Internal Med, Div Pulm Allergy & Crit Care Med, 59 Yatap Ro, Seongnam, South Korea

[2] Hanyang Univ, Guri Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Guri, South Korea

[3] Ewha Womans Univ, Coll Med, Dept Med, Div Pulm & Crit Care Med, Seoul, South Korea

[4] Univ Ulsan, Coll Med, Dept Pulm & Crit Care Med, Asan Med Ctr, Seoul, South Korea

[5] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju Severance Christian Hosp, Wonju, South Korea

[6] Keimyung Univ, Sch Med, Dongsan Med Ctr, Dept Internal Med, Daegu, South Korea

[7] Konkuk Univ, Sch Med, Dept Pulm & Crit Care Med, Seoul, South Korea

来源：

TUBERCULOSIS AND RESPIRATORY DISEASES | 2018年 / 81卷 / 04期

关键词：

Asthma; Pulmonary Disease; Chronic Obstructive; Phenotype;

D O I：

10.4046/trd.2017.0064

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

引用

页码：289 / 298

页数：10