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哮喘和 COPD“重叠”:一种可治疗的特征还是常见的多种可治疗特征?

Asthma and COPD "overlap": a treatable trait or common several treatable-traits?

机构信息

Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisboa, Portugal.

NOVA Medical School, Comprehensive Health Research Center (CHRC), Lisboa, Portugal.

出版信息

Eur Ann Allergy Clin Immunol. 2020 Jul 2;52(4):148-159. doi: 10.23822/EurAnnACI.1764-1489.138.

Abstract

In the last years, disease classification of chronic respiratory diseases (CRD) has been vivaciously discussed and new concepts have been introduced, namely asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO). Controversially the GOLD consensus document of 2020 considered that we should no longer refer to ACO, as they constitute two different diseases that may share some common traits and clinical features. The treatable traits approach has numerous strengths that are applicable to several levels of health care. In this paper we review the application of the treatable traits to CRD and describe in detail the ones already identified in patients with asthma and COPD. Treatable traits in CRD can be divided in pulmonary, extra-pulmonary and behavior/lifestyle risk factors. Patients with both asthma and COPD patients have clearly recognized treatable traits in all these subtopics but it is notorious the severe and frequent exacerbations, the associated cardiovascular disease and the low health related quality of life and productivity of these patients.

摘要

在过去的几年中,慢性呼吸系统疾病(CRD)的疾病分类一直备受关注,并且引入了新的概念,即哮喘-慢性阻塞性肺疾病(COPD)重叠(ACO)。有争议的是,2020 年 GOLD 共识文件认为,我们不应再提及 ACO,因为它们构成两种不同的疾病,可能具有一些共同的特征和临床特征。可治疗特征的方法具有许多优势,适用于多个医疗保健层次。在本文中,我们回顾了可治疗特征在 CRD 中的应用,并详细描述了已在哮喘和 COPD 患者中确定的特征。CRD 中的可治疗特征可分为肺部、肺外和行为/生活方式危险因素。哮喘和 COPD 患者都有明确的可治疗特征,但这些患者的严重和频繁的恶化、相关的心血管疾病以及较低的健康相关生活质量和生产力是众所周知的。

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