الفهرس 
Chronic Obstructive Pulmonary DiseaseOnly 14 pages are availabe for public view
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Abstract
Asthma-chronic obstructive pulmonary disease (overlap syndrome): is a major clinical problem in outpatient medical practice and has been attracting a lot of attention. Patients with ACOS present with more symptoms, and their severity is greater. Also, they experience more frequent exacerbations and their general condition deteriorates faster. Finally, ACOS patients are more frequently hospitalized.
This study was conducted at Embaba Chest Hospital during the period from July2014 and March 2015.
The aim of this study was to evaluate the prevalence of asthma-chronic obstructive pulmonary disease (overlap syndrome) in (Embaba Chest Hospital).
The study included 102 patients who were current COPD patients, selected from (Embaba Chest Hospital) outpatient clinic. This group was subjected to full history taking, detailed clinical examination, chest x-ray, demographic data acquisition, pulmonary function tests (spirometry) before and (15 minutes) after administration of salbutamol, serum IgE level evaluation.
Diagnosis of the overlap syndrome phenotype was done according to Spanish consensus document (2012) as follows:
It would be necessary for there to be 2 major criteria or 1 major and 2 minor criteria to correctly diagnose (ACOS).
The major criteria selected are:
Positive bronchodilator test (increase in FEV1≥15% and ≥400ml over baseline value).
Eosinophilia in sputum.
Personal history of asthma.
The minor criteria are:
High total IgE.
Personal history of atopy.
Positive bronchodilator test (increase in FEV1≥12% and≥200ml over baseline value) on 2 or more occasions.
The present study found that age of patients ranging from 25 to72 years with mean ±SD 54.77±10.1 years, all of them are males.
Ninety-seven (95%) of patients were smokers, the rest 5 (5%) were non smokers, with smoking index range from 4pack.year to 150 pack.year with mean± SD 40.22 ±27.33 for all patients.
The prevalence of the asthma-COPD overlap syndrome in the study population was 17.6% according to which we have divided the patients into two groups: ACOS group and COPD group.
As regards the socio-demographic distribution, there was significant difference between ACOS and COPD groups as regards the age; being significantly lower among ACOS group (p<0.05) than COPD group.
The mean age of COPD patients was 55.78±9.7years, whereas the mean age of ACOS patients was 50.05±10.75 years.
Meanwhile there were in significant difference between the two groups as regards gender.
In our study, Smoking index of ACOS range from 7 -105pack.year with mean± SD=42,9±29.06pack.year, and smoking index of COPD range from 4-150pack.year with mean± SD= 39,7± 27.41pack.year Smoking was significantly and positively associated with both groups (p>0.05), however the strength of the association was much higher for COPD than for the overlap syndrome.
As regards history of atopy, asthma among ACOS & COPD groups:
There was significant difference between ACOS and COPD groups as regards history of atopy; being significantly higher among ACOS group (p<0.01). Among subjects who reported the asthma-COPD overlap syndrome the percentage of atopy was (50%).
Also there was significant difference between the two groups as regards history of asthma; being significantly higher among ACOS group (p<0.01).
Among subjects who reported the asthma-COPD overlap syndrome the percentage of physician-diagnosed asthma was (77.8%).
The difference in age of onset of symptoms among ACOS & COPD groups was statistically significant (p<0.01), being earlier (before the age of 40 years) among ACOS patients (55.6%) whereas COPD patients mostly symptomatize above the age of 40 years (72.6%).
Regarding the spirometric data pre and (15) minutes after salbutamol administration, between the ACOS and COPD patients, There was highly significant statistical improvement in FEV1 and FEV1% among ACOS patients (p<0.01).
Regarding the comparison between ACOS and COPD patients according to mean value of IgE, showed high level of IgE in ACOS patients more than in COPD patients. The difference between both groups was found to be statistically significant.
As regards clinical presentations between the 2 groups there was no significant statistical difference between ACOS and COPD patients as regards dyspnea and chest wheezes ( p >0.05) whereas, there is statistically significant difference as regard cough and expectoration being more associated with ACOS patients (p≤0.05).