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2016 ; 11
(ä): 991-7
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Comparison of pulmonary function in patients with COPD, asthma-COPD overlap
syndrome, and asthma with airflow limitation
#MMPMID27274220
Kitaguchi Y
; Yasuo M
; Hanaoka M
Int J Chron Obstruct Pulmon Dis
2016[]; 11
(ä): 991-7
PMID27274220
show ga
BACKGROUND: This study was conducted in order to investigate the differences in
the respiratory physiology of patients with chronic obstructive pulmonary disease
(COPD), asthma-COPD overlap syndrome (ACOS), and asthma with airflow limitation
(asthma FL(+)). METHODS: The medical records for a series of all stable patients
with persistent airflow limitation due to COPD, ACOS, or asthma were
retrospectively reviewed and divided into the COPD group (n=118), the ACOS group
(n=32), and the asthma FL(+) group (n=27). All the patients underwent chest
high-resolution computed tomography (HRCT) and pulmonary function tests,
including respiratory impedance. RESULTS: The low attenuation area score on chest
HRCT was significantly higher in the COPD group than in the ACOS group (9.52±0.76
vs 5.09±1.16, P<0.01). The prevalence of bronchial wall thickening on chest HRCT
was significantly higher in the asthma FL(+) group than in the COPD group (55.6%
vs 25.0%, P<0.01). In pulmonary function, forced expiratory volume in 1 second
(FEV1) and peak expiratory flow rate were significantly higher in the asthma
FL(+) group than in the ACOS group (76.28%±2.54% predicted vs 63.43%±3.22%
predicted, P<0.05 and 74.40%±3.16% predicted vs 61.08%±3.54% predicted, P<0.05,
respectively). Although residual volume was significantly lower in the asthma
FL(+) group than in the COPD group (112.05%±4.34% predicted vs 137.38%±3.43%
predicted, P<0.01) and the ACOS group (112.05%±4.34% predicted vs148.46%±6.25%
predicted, P<0.01), there were no significant differences in functional residual
capacity or total lung capacity. The increase in FEV1 in response to short-acting
?2-agonists was significantly greater in the ACOS group than in the COPD group
(229±29 mL vs 72±10 mL, P<0.01) and the asthma FL(+) group (229±29 mL vs 153±21
mL, P<0.05). Regarding respiratory impedance, resistance at 5 Hz and resistance
at 20 Hz, which are oscillatory parameters of respiratory resistance, were
significantly higher in the asthma FL(+) group than in the COPD group at the
whole-breath (4.29±0.30 cmH2O/L/s vs 3.41±0.14 cmH2O/L/s, P<0.01 and 3.50±0.24
cmH2O/L/s vs 2.68±0.10 cmH2O/L/s, P<0.01, respectively), expiratory, and
inspiratory phases. CONCLUSION: Although persistent airflow limitation occurs in
patients with COPD, ACOS, and asthma FL(+), they may have distinct
characteristics of the respiratory physiology and different responsiveness to
bronchodilators.