哮喘-COPD重叠综合征相关性疾病166例分析  

Clinical analysis of asthma-COPD overlap syndrome in 166 cases reporters

作　　者：李超[1] 方圆[1] 李志奎[1] 

机构地区：[1]第四军医大学西京医院呼吸科,西安710032

出　　处：《中华肺部疾病杂志（电子版）》2015年第6期36-40,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金资助(81070028)

摘　　要：目的调查目前临床医生对哮喘-慢性阻塞性肺疾病重叠综合症(ACOS)诊断的认识,重申ACOS相关性疾病的五种分型及诊断,为临床对ACOS及相关疾病的进一步研究提供理论依据。方法利用嘉和电子病历平台医生工作站回顾性研究2015年1月1日至2015年5月22日西京医院呼吸科收治的166例患者的临床资料:包括支气管哮喘患者40例,哮喘患者3例及慢性阻塞性肺疾病(COPD)66例,慢性阻塞性肺疾病急性加重期患者53例,慢性阻塞性肺疾病合并肺部感染4例。按GOLD指南通过对患者发病年龄、现病史(呼吸症状的类型、病程)、既往史或家族史、肺功能检测、胸部CT检查结果重新诊断分析,并与原诊断对比。结果临床上尚无ACOS的诊断,仅有支气管哮喘急性发作期合并慢性阻塞性肺疾病急性加重期的诊断。以指南标准诊断后发现43例哮喘患者中,15例为单纯asthma,5例为possible asthma,23例为ACOS(其中3例漏诊为单纯asthma);123例COPD患者中,95例为单纯COPD,10例为possibly COPD,18例为ACOS。即166例病例中,标化后百分比,asthma占17%,possible asthma占6%,ACOS占34%,possibly COPD占4%,单纯COPD占39%。结论目前临床上对ACOS诊断的认识不足,对ACOS的治疗还停留在对支气管哮喘或慢性阻塞性肺疾病的单病诊治上,需对ACOS及相关疾病进一步研究。Objective To investigate the clinical diagnosis of asthma-COPD overlap syndrome（ ACOS）,to reaffirm the five kinds of ACOS related diseases,and to provide a theoretical basis for further research on ACOS and its related diseases. Methods The retrospective study from January 1,2015 to date May 22,2015,in Xijing Hospital were 166 cases of clinical data： 40 cases of patients with bronchial asthma,3 cases of patients with asthma and chronic obstructive pulmonary disease（ COPD） in 66 cases,chronic obstructive pulmonary disease acute exacerbation in patients with 53 cases,chronic obstructive pulmonary disease complicated with pulmonary infection in 4 cases by Jiahe electronic medical record platform doctor workstation. According to GOLD guidelines for patients with age,current history（ type of respiratory symptoms,duration）,past history or family history, pulmonary function testing, chest CT examination results, we compared thier diagnosis and analysis with the original diagnosis. Results there was no diagnosis of ACOS in clinic,and the diagnosis of acute exacerbation of chronic obstructive pulmonary disease with acute exacerbation of bronchial asthma. In 43 patients with asthma,15 were asthma,5 were possible asthma,23 were ACOS,3were asthma,In 123 patients with COPD,95 were COPD,10 were possibly COPD,18 were ACOS. In 166 cases,the percentage of asthma was 17%,possible asthma 6%,ACOS 34%,possibly COPD 4%,COPD39%. Conclusion the clinical diagnosis of ACOS is insufficient,and the treatment of ACOS is still in the treatment of bronchial asthma or chronic obstructive pulmonary disease. Further study on ACOS and its related diseases is needed.

关 键 词：支气管哮喘 肺疾病 慢性阻塞性 哮喘-COPD重叠综合征 

分 类 号：R563[医药卫生—呼吸系统]