材料来源Asthma-COPDoverlapsyndrome(ACOS.AdiagnosticchallengeNaUEWAATHOHYPARKANDWsuAAKANCYJJegpioyCaeConterUniesiyMedesnjb0MnbOiyeanDifsonofRinonayand0ficaltoeNedineDspatmertofMfedcheSnstngedialenerSugbunttenUhiesiySciooloflhdcpeScoulSoufMomsand:DifsonofjespieoedceDspstnentofMiefone5hgaUniesiyofMiejialScinceShgoJpanABSTRACTAeasereportijustatingthiseviewAalhmtcronletstricttePalmonarydletseaviableialogyCasefeportsfeatureofACOS,wereassociatedwithahigherprevRespirology(2016)21,410-418Mainteachinoints_,重境综合征是同时具有晕善和慢-ACOSisadis的(标大疫ini-tationcombinedLuziasthmal除了吸入激素和支气菅扩张药物外,8nCOPD,。|有2要明硝和排阿可遮免的危险因素,Inadditionto-dbron-chodilatortherapyrtimportanttoidentifyandeliminatem0d崛ab】eIiskfact0rSSuChassm0kmgTherapidrateioninACOSpatienttrmig门外八根贾仪挂皇标。,ofasthmaandsmok者引言Asthmaandchronicobstructivepulmonarydisease_(COPD)aretwoofthemostcommonlyencounteredchroniclungdiseasesinclinics.“heyarecharacter-izedbychronicinflammationandairwayremodel-ling,buttheydifferinthe覆anemsofinflammation,thestructuresaffectedandtheprimeanatomicsiteatWhichpathologicalcChangesocCUFInesedlfferences_thestructuresaffectedandtheprimeanatomicsiteatWhichpathologicalchangesoccur3esedifferencesaremostapparentwhenyoungnon-smokerswithasthmaandoldersmokerswithCOPDarecompared.HoweveritmaybeproblematictodifferentiateACOSinteepeienEiisiainAsthma(GINAandGlobalInitiativeforChronicObstructiveLungDisease(GOLD)providesaclinicaldeScnponofasthma-COPD_overlapSyndr0me:COSischaracterizedby腌赡-0yasS0clatedwIthCOPDACOSisthereforeidentifiedbythefeaturesthatitshareswithbothasthmaandBDWThisdescriptionisintuitivebutdifficulttoapplytodailyclinicalpractice.PhenotypeofCOPD?PrevalenceofACOSAC0S5hasnotbeendefneddefinitively8andisknownbydifferentnamesincludingoverlapsyn-dromeofasthmaandCOPD,mixedasthma-COPDphenotypellasthmacombinedwithCOPD,coexist-enceofasthmaandCOPD&orCOPDwithasthmaticfeaturesHOWbeenthemostcom-ImonlyusedterITable1CriteriafortheDiagnostsoftheMixedOPD-AsthmaPhenooypeUsedintheStudyMajorcriteriaPositivepostcbronchodilatortestwithanincreaseofFEVi15%and400mmlFENO40ppbPeronalhistoryofashmaWMinorcriterioElcvatedI8EinbloodPersonalhitoryofatopyPositivepostcbronchodilatortestwithanincrcaseofFEVi12%and200ml训aleas2山fferenCmeasuretmenGfFENO:ffactionalexhaledniticaddAdaptedfromSolerCataluiaetaL7DifferentcriteriadifferentoutcomeTable1TheprevalencsofACOSfomdiferentstudypopulstonsWithdiferetdiagnosticrteriStudyEfgbleag8DiagnostcorieriaPhevalencsFromthepopulatonfpatietswithasthmaMisneseal201255yeaDorumentedphysiiamdiagnosedasthma+clisscal。28%symplomofchonicbronditsandorDLo仪ppbandPesonalhistoofasthme。MinoroierielwatedserumlgpersonalhisonfofalopyandpostBDFEViinerase12%and2200mLoverbaselne002fmore0CasionsBurdenofACOSDActhmascopoOvedapzyndroms,_o|34-44yeers45-54yesrs55-54years65-74years75-84yesrs65yearsa口一vMaannumbwroltsatmentpoflodsperpatint、AndersenH.HighhospitalburdeninoverlapsyndromeofasthmaandCOPD.Clin.RespirJ2013;7:342-6.