Clinical Characteristics Of Asthma-COPD Overlap Syndrome

Objective To investigate the differences of clinical manifestations and related test indexes between patients with asthma-chronic obstructive pulmonary disease overlap syndrome?ACOS?and patients with chronic obstructive pulmonary disease?COPD?.Methods The clinical data of 48 patients with ACOS and 60 patients with COPD were collected from July 2015 to December 2016 in Department of Respiratory,affiliated Hospital of Southwest Medical University.Results The mean age of the patients with overlapping syndrome of chronic pulmonary obstruction was 72.31 ±10.74 years old.The average age of chronic pulmonary disease group was 60.76 ±10.56 years old.The proportion of smoking history in COPD group was significantly higher than that in COPD group?P < 0.05?.The proportion of smoking history in chronic pulmonary disease group was 95.00 and the difference was significant?P < 0.05?.The proportion of lung moist rale was lower than that of COPD group?P < 0.05?.The proportion of lung gas and bullae in CT was lower than that in COPD group?P < 0.05?.The proportion of allergic history in ACOS group was higher than that in COPD group.The first symptom was the proportion of patients with shortness of breath,the proportion of lung sign accompanied by wet rale was higher than that of COPD group?P < 0.05?,the pulmonary function index,blood gas index and airway inflammation index were compared between the two groups.The results showed that the forced respiratory volume at 1 seconds in the ACOS group was lower than that in the COPD group.The levels of Paco₂,no and Feno in COPD group were higher than those in COPD group?P < 0.05?,the laboratory indexes of ACOS group were compared with that of ACOS group,such as total immunoglobulin IgE,Gao Min C-reactive protein hs-CRP,white blood cell count?WBC?,neutrophil ratio.The eosinophil level was higher than that in COPD group?P < 0.05?.Conclusion The proportion of elderly patients in ACOS group was higher.Most of the patients had allergic history,the lung signs were mostly accompanied by dry and wet rales,and the patients' lung function damage was generally serious.The clinical signs of most patients with ACOS are more complicated than those of patients with chronic pulmonary obstruction.The symptoms of ACOS are incomplete reversibility,persistent airflow limitation,moderate pulmonary ventilation dysfunction and mild emphysema.Compared with the COPD group,the pulmonary function of ACOS is generally worse,the acute exacerbation is more frequent,the corresponding medical expenditure level is higher,and the complications are more.