الفهرس 
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Abstract
This study was performed on 60 stable patients with COPD randomly selected from outpatient clinics of Chest department at Minia University Hospital in the period from September 2015 to September 2016.
All patients were subjected to history taking and physical examination (mMRC) dyspnea scale, CAT questionnaire, Chest Radiograph, (ABGs : PaO2,PaCO2,O2 saturation) ,pulmonary function tests ( FEV1, FVC, FEV1/FVC and DLCO ) % predicted, COPD combined assessment for severity according to (GOLD,2016), ,CBC and Sputum Cellular analysis.
Pateints of ACOS were diagnosed by fulfilling any of the following criteria:
1-Post-bronchodilator FEV/FVC <70% and history of bronchial asthma before age of forty (40) years old (Hardin et al .,2011).
2-Post-bronchodilator FEV/FVC <70% and reversibility of FEV1 after bronchodilator ≥ 200 ml and 12% associated with wheezy chest in the last year (Menezes et al .,2014).
According to this criteria, the 60 patients were classified into 2 groups :
group A: 36 patients with COPD alone.
group B: 24 patients with ACOS.
Also we applied two other different diagnostic criteria of ACOS on :
1-All the sixty patients to see the difference in the frequency by using different definitions.
2-group B (ACOS patients diagnosed by the method used above) to see if they still fulfilled the criteria of being ACOS or not.
The 1st definition is based on the Spanish consensus (Soler-Cataluñaet al.,2012).
The 2nd definition is based on GINA-GOLD,2015 document when patient had similar number of features for asthma and COPD.
This study aimed to determine the frequency of ACOS in stable COPD patients, compare the two groups as regard clinical, laboratory, functional parameters.
The results revealed that the frequency of ACOS in COPD patients was 40%, but when the Spanish consensus and GINA-GOLD,2015 definitions for ACOS were used the frequency fell to 13.3% and 10% respectively.
There was no significant difference between ACOS patients and pure COPD patients as regard sex, age, smoking history, dyspnea, exacerbations or most PFTs.
CAT score and percentage of sputum eosinophils were significantly higher in ACOS patients.
There was no significant correlation between FEV1 % and both CAT score in ACOS patients, but there was negative correlation between FEV1 % and CAT score in COPD patients.