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目的观察糖皮质激素(ICS)联合长效β2受体激动剂(LABA)吸入治疗哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)的短期疗效。方法收集2012年3月至2015年3月期间来我院诊治后病情稳定的ACOS及慢性阻塞性肺疾病(COPD)患者即ACOS组、COPD组。完善肺功能检查、胸片、血嗜酸性粒细胞计数及生活质量(m MRC)评分,符合纳入标准的ACOS组(36例)和COPD组(88例)规律使用ICS联合LABA吸入治疗,3个月后复查以上指标。结果 ICS联合LABA吸入治疗3个月后,ACOS组及COPD组肺功能指标(FEV1、FVC、TLC、RV、IC、DLco)及m MRC均得到改善。ACOS组第1秒用力呼气容积(FEV1)指标改善较COPD组明显(P<0.05),尤其是在轻至中度气流受限的患者中两组FEV1改变更为明显[(250.2±42.9)vs.(63.1±25.3)mL,P=0.003],在重度至极重度组治疗后两组FEV1的改善无统计学意义。结论 ICS联合LABA吸入治疗ACOS患者较COPD患者有明显的疗效,轻-中度ACOS患者治疗后肺功能改善更为明显。
Objective To observe the short-term efficacy of glucocorticoid (ICS) combined with long-acting β2 receptor agonist (LABA) inhalation in the treatment of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Methods The ACOS and COPD patients with stable ACOS and chronic obstructive pulmonary disease (COPD) were collected from March 2012 to March 2015 in our hospital. The pulmonary function test, chest X-ray, blood eosinophil count and quality of life (m MRC) scores were used to evaluate the compliance with the accepted criteria of ACOS group (36 cases) and COPD group (88 cases) After reviewing the above indicators. Results After three months of ICS combined with LABA inhalation, the pulmonary function parameters (FEV1, FVC, TLC, RV, IC, DLco) and m-MRC were improved in ACOS group and COPD group. FEV1 index in ACOS group was significantly improved compared with COPD group (P <0.05), especially in patients with mild to moderate airflow limitation, FEV1 changes were more obvious in both groups (250.2 ± 42.9) (63.1 ± 25.3) mL, P = 0.003]. There was no significant difference in improvement of FEV1 between the two groups after treatment in severe to very severe group. Conclusions ICS combined with LABA inhalation has obvious curative effect on chronic obstructive pulmonary disease (ACOS) patients compared with patients with chronic obstructive pulmonary disease (COPD). The improvement of pulmonary function in patients with mild to moderate ACOS is more obvious.