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URL : https://hal.archives-ouvertes.fr/hal-01813294
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, Etude de la prévalence et des caractéristiques des ACOS parmi la cohorte de BPCO du CHU d'Amiens Introduction : Le syndrome de chevauchement asthme-BPCO (ACOS) pourrait être un phénotype de BPCO. L'objectif était d'estimer la prévalence des patients répondant aux critères d'ACOS
Une étude rétrospective a été menée entre mai 2017 et mai 2018 sur la cohorte de BPCO du CHU d'Amiens. Deux définitions étaient utilisées en l'absence de définition consensuelle : un score diagnostique basé sur les critères du GINA ,
6%) patients présentaient un ACOS suivant respectivement la définition du score diagnostique et celle du consensus, prévalence modifiée à 43 (32,1%) et 16 (11,2%) sur 134 patients BPCO après exclusion des patients emphysémateux et des patients n'ayant pas un trouble ventilatoire confirmé. Les patients ACOS étaient moins graves (VEMS à 67,9% vs 58.6%, p=0.024, BODE index 0.8 vs 1.79, p<0.001) mais aussi exacerbateurs fréquents (p=0.47) que les patients BPCO. Les patients ACOS étaient plus souvent asthmatiques (p<0.001) et avaient plus souvent des symptômes précoces (p<0.001), des antécédents personnels (p=0.021) ou familiaux d'allergie (p=0.023), une hyperéosinophilie (p=0.017) ou des IgE totales élevées (p=0.008) ,
, à 32,1% répondent aux critères d'ACOS. Il s'agit de patients moins sévères mais tout aussi exacerbateurs fréquents que les BPCO, plus souvent associés à une hyperéosinophilie et à des antécédents personnels ou familiaux d'asthme ou d'allergie. La réversibilité des EFR semble être un critère ni nécessaire ni suffisant, Conclusion : Parmi les patients suivis pour une BPCO au CHU d'Amiens, vol.11
, Mots clefs : BPCO ; asthme ; ACOS ; trouble ventilatoire obstructif
Prevalence and characteristics of ACOS among COPD cohort in Amiens University Hospital. Introduction: Asthma-and-COPD overlap syndrome (ACOS) could be a COPD phenotype. We aimed to determine prevalence and characteristics of patients who could be, ACOS in the Amiens University Hospital COPD cohort ,
, Two definitions were used because of the lack of an official definition: a diagnostic score based on GINA standards, and one diagnostics proposed by an expert consensus. Results: Among all COPD patients, 49 (13,3%) et 17 (4.6%) were ACOS respectively following the score definition and the consensus definition, and 43 (32,1%) and 16 (11,2%) among 134 COPD patients after removing emphysematous patients and non-confirmed obstructive trouble. ACOS people were less serious (FEV1: 67,9% vs 58.6%, p=0.024, BODE index 0.8 vs 1.79, p<0.001) but as frequents exacerbators as non-ACOS COPD patients (p=0.47). ACOS patients had more often asthma (p<0.001), early symptoms (p<0.001), familial (p=0.023) or personal (p=0.021) allergy, hypereosinophilia (p=0.017) or high total IgE (p=0.008). No difference was seen in spirometrics, Methods: We conducted a retrospective study from may 2017 to may 2018 among the Amiens University Hospital COPD cohort