职业性哮喘患者哮喘-慢性阻塞性肺疾病重叠的临床和炎症特征。
Clinical and inflammatory characteristics of Asthma-COPD overlap in workers with occupational asthma.
机构信息
Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Montréal, Quebec, Canada.
CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.
出版信息
PLoS One. 2018 Mar 2;13(3):e0193144. doi: 10.1371/journal.pone.0193144. eCollection 2018.
INTRODUCTION
Although Asthma-COPD Overlap (ACO) has been described among populations of subjects with COPD or asthma, ACO has never been described among a population of subjects with occupational asthma (OA).
OBJECTIVES
The aims of this study were to: 1. identify ACO in a population of subjects with OA; and 2. compare the clinical characteristics between ACO and OA.
METHODS
This retrospective study included all subjects diagnosed with OA between 2000 and 2017 in an OA referral center. Occupational Asthma-COPD Overlap (OACO) was defined as post-bronchodilator FEV1/FVC < 70% and smoking history ≥ 10 pack-years, along with a diagnosis of OA.
RESULTS
Three hundred and four subjects were included, 262 (86.2%) were classified as OA and 42 (13.8%) as OACO. OA subjects presented higher sputum eosinophil counts after a specific-inhalation challenge than subjects with OACO (median [IQR]: 6.5 [17.0] vs 2.3 [3.5]). After adjusting for confounding factors, subjects with OACO were older (OR: 1.10 [1.05; 1.14]) and were taking higher doses of inhaled corticosteroids than OA subjects (OR, 5.20 [1.77; 16.48]). Subjects with OACO were less often atopic than OA subjects (OR, 0.19 [0.07; 0.62]).
CONCLUSIONS
Subjects with OACO constitute a distinct clinical and inflammatory phenotype from subjects with OA.
简介
虽然哮喘-慢性阻塞性肺疾病重叠（ACO）在 COPD 或哮喘患者人群中已有描述，但在职业性哮喘（OA）患者人群中从未描述过 ACO。
目的
本研究的目的是：1. 在 OA 患者人群中确定 ACO；2. 比较 ACO 和 OA 的临床特征。
方法
本回顾性研究纳入了 2000 年至 2017 年间在 OA 转诊中心诊断为 OA 的所有患者。职业性哮喘-慢性阻塞性肺疾病重叠（OACO）定义为支气管扩张剂后 FEV1/FVC<70%且吸烟史≥10 包年，同时诊断为 OA。
结果
共纳入 304 例患者，262 例（86.2%）归类为 OA，42 例（13.8%）归类为 OACO。与 OACO 患者相比，OA 患者在特定吸入性挑战后痰液嗜酸性粒细胞计数更高（中位数[IQR]：6.5[17.0]比 2.3[3.5]）。在校正混杂因素后，OACO 患者年龄更大（OR：1.10[1.05; 1.14]），吸入性皮质激素剂量高于 OA 患者（OR，5.20[1.77; 16.48]）。与 OA 患者相比，OACO 患者的变应性较低（OR，0.19[0.07; 0.62]）。
结论
与 OA 患者相比，OACO 患者构成了一种独特的临床和炎症表型。
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