重叠综合症课件

ACOS呼吸内科.ACOS呼吸内科.材料来源.材料来源.Mainteachingpoints重叠综合征是同时具有哮喘和慢阻肺特点的气流受限性疾病除了吸入激素和支气管扩张药物外，有必要明确和排除可避免的危险因素，比如吸烟。肺功能快速下降的重叠综合征病人多见于哮喘合并吸烟的患者.Mainteachingpoints重叠综合征是同时具有引言.引言.ACOS.ACOS.PhenotypeofCOPD?asthmaACOSCOPD.PhenotypeofCOPD?asthmaACOSCPrevalenceofACOS.PrevalenceofACOS...Differentcriteriadifferentoutcome.DifferentcriteriadifferentoBurdenofACOSAndersenH.HighhospitalburdeninoverlapsyndromeofasthmaandCOPD.Clin.Respir.J.2013;7:342–6..BurdenofACOSAndersenH.HighFattahiF.AtopyisariskfactorforrespiratorysymptomsinCOPDpatients:resultsfromtheEUROSCOPstudy.

Respir.Res.2013;14:10..FattahiF.Atopyisariskfac..ChungJW,KongKA,LeeJH,LeeSJ,RyuYJ,ChangJH.Characteristicsandself-ratedhealthofoverlapsyndrome.Int.J.Chron.Obstruct.Pulmon.Dis.2014;9:795–804..ChungJW,KongKA,LeeJH,LeePATHOPHYSIOLOGYOFACOS基因GENE病理和气道功能STRUCTURALCHANGES临床表现MANIFESTATION.PATHOPHYSIOLOGYOFACOS基因GENE.GeneTh2inflamation.GeneTh2inflamation.......CigarettesmokingcanalterairwayinflammationinasthmafrombeingeosinophilictoneutrophilicwithincreasedCD8+cells,thusbecomingsimilartothatseeninCOPD..CigarettesmokingcanalteraiStep-wiseapproachtodiagnosingACOS.Step-wiseapproachtodiagnosiAsthmaACOSchildhoodasthmawithpersistentwheezefromthefirstyearsoflifeintoadulthoodLongstandingasthmawithouttakingICSadult-onsetasthmasevereordifficult-to-treatasthma.AsthmaACOSchildhoodasthma..COPDACOS.COPDACOS.Avaliablefeatures对慢阻肺患者如果在40岁以前被医生诊断过哮喘，该病人推荐诊断ACOS.Avaliablefeatures对慢阻肺患者如果在40岁RecallbiasLackoflungfunctiontestingtypicalsymptomsandrespondtoICSthoroughinterviewEosACOSSpirometry.RecallbiasthoroughinterviewEGINAandGOLD.Diagnosisofdiseasesofchronicairflowlimitation:asthma,COPDandasthma-COPDoverlapsyndrome

(ACOS)(updated2015).AvailablefromURL:http://

/.Accessed:13April2015..GINAandGOLD.Diagnosisofdi..SputumEosinophilCounts.SputumEosinophilCounts.....Management.Management...Individualizedmanagement

ICSmaybeconsideredinpatientswithACOSwithsignificantsputumeosinophilia(eosinophilcount≥3%)..IndividualizedmanagementICSDisability.Disability.FutureACOSStudiesFirst,whichgenesarethegeneticriskfactorsfordevelopingACOS?thesecondquestioniswhatarethemolecularpathwaysofACOS?Third,whatisthenaturalcourseorprognosisofACOS?.FutureACOSStudiesFirst,whicConclusionsACOSmaybeaninterimtermapplicabletopatientsinwhomitisdifficulttodistinguishbetweenasthmaandCOPD.Analternative