Astım-KOAH overlap sendromu
Küçük Resim Yok
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Astım-KOAH overlap sendromuAstım ve kronik obstrüktif akciğer hastalığı (KOAH), kronik hava yolu inflamasyonu ve hava yolu obstrüksiyonu ile karakterize olan ve toplumda sık görülen akciğer hastalıklarıdır. KOAH ve astımlı olgular arasında her iki hastalık için hava yolu inflamasyonunun ve dolayısıyla klinik, fonksiyonel özelliklerin örtüştüğü "Astım-KOAH Overlap Sendromu" (AKOS) olarak tanımlanan hastalar bulunmaktadır. AKOS; persistan hava akımı kısıtlaması (postbronkodilatör FEV/FVC < %70) ve reverzibilite ile karakterize, hem astım hem KOAH'ın bazı özelliklerini taşıyan bir sendromdur. Kırk yaş üzeri, sigara içmiş ve çocukluğunda astım öyküsü veya doktor tanılı astımı olan ve persistan hava akımı kısıtlaması ile birlikte reverzibl hava yolu obstüksiyonu (400 mcg salbutamol veya 1000 mcg terbutalin inhalasyonu sonrasında FEV'de bazal değere göre > %12 ve > 200 mL artış) olan hastada AKOS düşünülmelidir. AKOS prevalansı farklı hasta serilerinde %11-55 oranlarında bildirilmektedir. Yaşla birlikte AKOS oranı artmakta ve her yaş diliminde kadınlarda daha sık görülmektedir. AKOS'lu hastaların; KOAH'a göre genç ama astıma göre daha ileri yaşta hastalar olduğu ve daha semptomatik oldukları gösterilmiştir. Sık ve ağır atak geçirme, bu nedenle hastaneye yatış veya acile başvuru AKOS'ta sıktır ve bu durum hastaların yaşam kalitelerini olumsuz yönde etkilemektedir. Rehberlerde AKOS'un farmakolojik tedavisi astım ve KOAH için var olan en uygun tedavi seçeneklerinin kombinasyonundan oluşmaktadır. Gelecekte ortaya çıkacak tedaviler endotipe dayalı olmalıdır. Klinik fenotip ve altta yatan endotipe yönelik yapılacak klinik çalışmalar gelecekte yazılacak AKOS rehberlerinin temelini oluşturacaktır.
Asthma-COPD overlap syndromeAsthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named "Asthma-COPD Overlap Syndrome" (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV pred or increase of FEV > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines.
Asthma-COPD overlap syndromeAsthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named "Asthma-COPD Overlap Syndrome" (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV pred or increase of FEV > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Solunum Sistemi
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Cilt
63
Sayı
4
