Phenotyping chronic respiratory diseases with airways obstruction.

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES International Journal of Tuberculosis and Lung Disease Pub Date : 2024-06-01 DOI:10.5588/ijtld.23.0383
T C Nguyen, H V T Tran, M H T Tran, I Godin, O Michel
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Abstract

BACKGROUNDGiven the high prevalence of asthma-chronic obstructive pulmonary disease overlap (ACO) in Vietnam, there is an urgent need to establish a simplified strategy for categorising patients as either having asthma or chronic obstructive pulmonary disease (COPD). This classification would streamline the application of treatment recommendations outlined by the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).METHODSPatients with obstructive lung function were classified as having COPD, asthma, or ACO based on GINA/GOLD guidelines. We hypothesised that ACO-like asthma (ACO-A) would present with positive skin prick tests (SPTs) or early onset of symptoms without a history of tuberculosis (TB), while those with ACO-like COPD (ACO-B) would exhibit negative SPTs and late onset of symptoms and/or a history of TB.RESULTSAmong 235 patients, the prevalence of asthma, ACO-A, ACO-B, and COPD was respectively 21%, 22%, 17%, and 40%. Allergic history, rhinitis, and childhood asthma were associated with ACO-A, while high cumulative smoking was correlated with ACO-B. Socio-economic and demographic parameters, medical history, clinical features, smoking habits, lung function, and para-clinical investigations significantly differed between "all asthma" (i.e., individuals with asthma combined with ACO-A) and "all COPD" (i.e., individuals with COPD combined with ACO-B).CONCLUSIONBased on SPTs, history of TB, and onset age, ACO patients may be defined as people with asthma or COPD..

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对气道阻塞的慢性呼吸道疾病进行表型分析。
背景鉴于越南哮喘与慢性阻塞性肺病重叠(ACO)的发病率很高,因此迫切需要制定一种简化策略,将患者分为哮喘和慢性阻塞性肺病(COPD)两类。方法根据全球哮喘倡议(GINA)和全球慢性阻塞性肺病倡议(GOLD)指南,将具有阻塞性肺功能的患者分为慢性阻塞性肺病(COPD)、哮喘或 ACO。我们假设类似 ACO 的哮喘(ACO-A)患者皮肤点刺试验(SPT)呈阳性或症状出现较早且无结核病史,而类似 ACO 的慢性阻塞性肺病(ACO-B)患者皮肤点刺试验(SPT)呈阴性且症状出现较晚和/或有结核病史。过敏史、鼻炎和儿童哮喘与 ACO-A 相关,而大量累积吸烟与 ACO-B 相关。社会经济和人口学参数、病史、临床特征、吸烟习惯、肺功能和辅助临床检查在 "所有哮喘"(即合并 ACO-A 的哮喘患者)和 "所有慢性阻塞性肺病"(即合并 ACO-B 的慢性阻塞性肺病患者)之间存在显著差异。
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来源期刊
CiteScore
4.90
自引率
20.00%
发文量
266
审稿时长
2 months
期刊介绍: The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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