Brzostek Dorota, Kokot Marek
Takeda Poland.
Postepy Dermatol Alergol. 2014 Dec;31(6):372-9. doi: 10.5114/pdia.2014.47120. Epub 2014 Dec 3.
Recent years have seen an increased interest in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS).
In 2012, Takeda Polska conducted a non-interventional epidemiological study aimed at identifying the typical phenotype of ACOS patients receiving pulmonary care.
The study enrolled a total of 12,103 of smoking patients above 45 years of age (mean age: 61.5 years; mean duration of smoking: 28.4 pack-years). A total of 68.6% of patients represented the frequent-exacerbation phenotype (mean number of exacerbations during 12 months: 2.11), and 56.4% of patients from the group comprising 12,103 participants were hospitalized at least once during their lifetime due to a respiratory system disease (mean number: 3.82 ±3.76).
The most commonly found asthma symptoms included paroxysmal dyspnoea with wheezing, and good response to inhaled steroids. The most frequently identified COPD-associated symptoms were: long-lasting reduction in forced expiratory volume in 1 s (FEV1) (< 80% after administering a bronchodilator) and chronic productive cough. Eighty-five percent of patients were diagnosed with concomitant diseases, predominantly arterial hypertension (62.9%) and metabolic diseases (metabolic syndrome, obesity, type 2 diabetes - 46.4% in total).
A clinically severe course of ACOS and the presence of concomitant diseases should be regarded as factors justifying an individual selection of inhalation therapy which specifically takes into account anti-inflammatory treatment and patient safety.
近年来,人们对哮喘-慢性阻塞性肺疾病(COPD)重叠综合征(ACOS)的关注度日益增加。
2012年,武田波兰公司开展了一项非干预性流行病学研究,旨在确定接受肺部护理的ACOS患者的典型表型。
该研究共纳入了12103名45岁以上的吸烟患者(平均年龄:61.5岁;平均吸烟史:28.4包年)。共有68.6%的患者表现为频繁加重型表型(12个月内平均加重次数:2.11次),在这12103名参与者中,56.4%的患者因呼吸系统疾病在其一生中至少住院一次(平均次数:3.82±3.76次)。
最常见的哮喘症状包括伴有喘息的阵发性呼吸困难,以及对吸入性类固醇反应良好。最常发现的与COPD相关的症状为:1秒用力呼气容积(FEV1)长期降低(使用支气管扩张剂后<80%)和慢性咳痰。85%的患者被诊断患有合并症,主要为动脉高血压(62.9%)和代谢性疾病(代谢综合征、肥胖症、2型糖尿病,总计46.4%)。
ACOS的临床严重病程和合并症的存在应被视为合理选择吸入疗法的因素,吸入疗法应特别考虑抗炎治疗和患者安全。