THE DECREASE OF FEF25-75 IS MORE SPECIFIC FOR ASTHMA THAN COPD

Öz

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Anahtar Kelimeler

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THE DECREASE OF FEF25-75 IS MORE SPECIFIC FOR ASTHMA THAN COPD

Öz

Aim: Nowadays, there are still some difficulty to distinguish smoker asthmatic patients and COPD. Differentiation of these disorders is very important as their treatment choices are different. The aim of this study is to investigate the presence of auscultation together with pulmonary function test (PFT) findings and the power of these findings in distinguishing asthma and COPD patients. Methods: 585 patients diagnosed of asthma and COPD according to international guidelines in our out-patient clinic were reviewed and their semptoms, risk factors, physical exam findings and PFTs were evaluated. Results: The study consisted of 294 women and 291 men. The mean age of patients was 41.2±14.5 years. 433 patients were asthmatic and 152 had COPD. While there was a significantly concordance between auscultation and PFTs in non-smoker patients with asthma (p=0.00), we didn’t find any accordance in smoker patients with asthma and COPD (p>0.05), If auscultation was normal and only FEF25-75 parameter showing obstruction in PFT was lower this condition was found more specific for asthma (without cigarette influence) than COPD (p=0.000). Conclusion: Our data shows that abnormal findings of auscultation and PFTs were more concordance in non-smoker patients with asthma. This indicates that PFTs may be utilized noninvasively to distinguish asthma and COPD cases in outpatient clinics

Anahtar Kelimeler

• Asthma, COPD, FEF25-75

Kaynakça

1. Global strategy for asthma management and prevention: update report 2006. NIH Publication No. 02–3659. Available at: www.ginasthma.com.
2. NHLBI/WHO global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;163,1256-1276
3. Bergeron C, Boulet LP. Structural changes in airway diseases: characteristics, mechanisms, consequences, modulation. Chest 2006;129(4):1068-87
4. Buist AS. Similarities and differences between asthma and chronic obstructive pulmonary disease: treatment and early outcomes. Eur Respir J Suppl 2003;39:30s-35s
5. Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM. From bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med 2000;161:1720–45
6. Hamid Q, Song YL, Kotsimbos TC, et al. Inflammation of small airways in asthma. J Allergy Clin Immunol 1997;100:44–51.
7. Martin RJ. Small airway and alveolar tissue changes in nocturnal asthma. Am J Respir Crit Care Med 1998;157:5188–190
8. Laitinen LA, Laitinen A, Altraja A, et al. Bronchial biopsy findings in intermittent or “early” asthma. J Allergy Clin Immunol 1996;98:53–6

9. Jeffery PK. Structural and inflammatory changes in COPD: a comparison with asthma. Thorax 1998;53:129–36
10. Barnes PJ. Chronic obstructive pulmonary disease. N Engl J Med 2000;343:269–80
11. Guerra S. Overlap of asthma and chronic obstructive pulmonary disease. Curr Opin Pulm Med 2005;11(1):7-13
12. Sussman R. Part I: Identifying chronic obstructive pulmonary disease in patients with respiratory symptoms. Curr Med Res Opin 2007;23 Suppl 3:S5-12
13. Buffels, J, Degryse, J, Heyrman, J, et al Office spirometry significantly improves early detection of COPD in general practice: the DIDASCO study. Chest 2004;125;1394-9
14. S. Dreborg, Skin tests used in type 1 allergy testing (position paper), Allergy 1989; 44 (suppl.10):22–30
15. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38
16. American Thoracic Society. Guidelines for methacholine and exercise challenge testing-1999. Am J Respir Crit Care Med 2000;161;309-29
17. Althuis, M, Sexton, M, Prybylski, D Cigarette smoking and asthma severity among adult asthmatics. J Asthma 1999;36;257-64
18. Zevin, S, Saunders, S, Gourlay, SG, et al Cardiovascular effects of carbon monoxide and cigarette smoking. J Am Coll Cardiol 2001;38,1633-8
19. Siroux, V, Pin, I, Oryszczyn, M, et al Relationships of active smoking to asthma and asthma severity in the EGEA study. Eur Respir J 2000;15;470-7
20. Thomson, NC, Chaudhuri, R, Livingston, E Active cigarette smoking and asthma. Clin Exp Allergy 2003;33;1471-5
21. Marco, M, Minette, A Lung function changes in smokers with normal conventional spirometry. Am Rev Respir Dis 1976;114;723-38
22. Bosken, CH, Hards, J, Gatter, K, et al Characterization of the inflammatory reaction in the peripheral airways of cigarette smokers using immuno-histochemistry. Am Rev Respir Dis 1992;145;911-7
23. Casale, TB, Rhodes, BJ, Donnelly, AL, et al Airway responses to methacholine in asymptomatic nonatopic cigarette smokers. J Appl Physiol 1987;62;1888-92
24. Chalmers, GW, MacLeod, KJ, Thomson, L, et al Smoking and airway inflammation in patients with mild asthma. Chest 2001;120,1917-22
25. Pedersen, B, Dahl, R, Karlstrom, R, et al Eosinophil and neutrophil activity in asthma in a one-year trial with inhaled budesonide: the impact of smoking. Am J Respir Crit Care Med 1996;153,1519-29
26. Boulet LP, Lemière C, Archambault F, Carrier G, Descary MC, Deschesnes F. Smoking and asthma: clinical and radiologic features, lung function, and airway inflammation. Chest 2006;129(3):661-8
27. Moreno R, Hogg JC, Pare PD. Mechanics of airway narrowing. Am Rev Respir Dis 1986;133:1171–80
28. James Al, Pare PD, Hogg JC. The mechanics of airway narrowing in asthma. Am Rev Respir Dis 1989;139:242–6
29. Wiggs BR, Moreno R, Hogg JC, Hilliam C, Pare PD. A model of the mechanics of airway narrowing. J Appl Physiol 1990;69:849–60
30. Levine G, Housley E, MacLeod P, Macklem PT. Gas exchange abnormalities in mild bronchitis and asymptomatic asthma. Engl J Med 1970;282(23):1277-82
31. Tulic MK, Hamid Q. New insights into the pathophysiology of the small airways in asthma. Clin Chest Med. 2006;27(1):41-52