Çelik Gülfem Elif, Aydin Ömür, Şen Elif, Demir Tunçalp, Gemicioğlu Bilun, Kiyan Esen, Mungan Dilşad, Kivilcim Oğuzülgen İpek, Polatli Mehmet, Göksel Özlem, Sayiner Abdullah, Yildirim Nurhayat, Yildiz Füsun, Yorgancioğlu Arzu, Elhan Atilla Halil, Yildiz Öznur, Başyiğit İlknur, Börekçi Şermin, Havlucu Yavuz, Okumuş Gülfer, Türk Murat, Saryal Sevgi
Division of Immunology and Allergy, Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Türkiye.
Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Türkiye.
Tuberk Toraks. 2024 Mar;72(1):25-36. doi: 10.5578/tt.202401886.
Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye.
The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups.
The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radiologic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p<0.001). The annual decline in FEV1 was more prominent in the ACO group (mean= -250 mL) than in the asthma (mean change= -60 mL) and COPD (mean change= -230 mL) groups (p= 0.003).
This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovementioned symptoms.
哮喘-慢性阻塞性肺疾病(COPD)重叠综合征(ACO)患者的疾病负担比单纯患有COPD或哮喘的患者更重。在本研究中,由于土耳其国内相关数据有限,旨在确定ACO的患病率、危险因素及临床特征。
本研究采用横断面设计,在9家三级医疗医院进行。纳入至少随访1年且诊断为哮喘或COPD的患者。对哮喘组和COPD组中ACO的发生率及患者特征进行评估。
本研究纳入408名受试者(男/女 = 205/203,平均年龄 = 56.24 ± 11.85岁)。两组中ACO的总体患病率为20.8%(n = 85)。COPD组的发生率高于哮喘组(分别为n = 55;33.3% 对比 n = 22;9.8%)(p = 0.001)。ACO患者在高龄、性别、吸烟、童年期接触生物质燃料、出生于农村地区及放射学特征方面与COPD患者相似。童年哮喘病史、过敏性鼻炎、慢性鼻窦炎、非甾体抗炎药超敏反应、特应性及高嗜酸性粒细胞计数等特征与哮喘患者相似(p < 0.001)。ACO组第一秒用力呼气容积(FEV1)的年下降幅度比哮喘组(平均变化 = -60 mL)和COPD组(平均变化 = -230 mL)更显著(平均 = -250 mL)(p = 0.003)。
本研究表明,在我国三级医疗诊所中,ACO在哮喘和COPD患者中很常见。对于出现上述症状的哮喘和COPD患者应考虑ACO。