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aunque los puntos de corte &#243;ptimos no est&#225;n claramente establecidos&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La medici&#243;n del &#243;xido n&#237;trico en aire exhalado como marcador de inflamaci&#243;n en la v&#237;a a&#233;rea ha observado un gran desarrollo en las &#250;ltimas d&#233;cadas&#44; permitiendo en la actualidad&#44; mediante la aplicaci&#243;n de diferentes ecuaciones&#44; separar el componente alveolar o de la v&#237;a a&#233;rea distal &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; del componente bronquial central<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">9&#8211;11</span></a> &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46; El an&#225;lisis de ambos componentes ha sido m&#225;s extensamente estudiado en pacientes con asma bronquial&#44; en donde se aprecia un aumento del componente alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; en los pacientes con asma m&#225;s grave&#44; lo que traduce mayor inflamaci&#243;n a este nivel<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; Adem&#225;s&#44; la medici&#243;n del <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> puede ayudar a identificar a pacientes susceptibles de mejorar con el empleo de corticoides inhalados &#40;CI&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> as&#237; como a pacientes con mayor riesgo de comorbilidad<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En pacientes con EPOC&#44; la medici&#243;n del &#243;xido n&#237;trico en aire exhalado &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#41; ha demostrado ser capaz de discriminar diferentes tipos de pacientes<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">16&#44;17</span></a> y estar asociada a la presencia de eosin&#243;filos en esputo<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">18&#44;19</span></a>&#44; un hallazgo caracter&#237;stico del ACO&#46; Por otra parte&#44; los niveles de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> son un buen predictor de respuesta al empleo de CI<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;21</span></a>&#46; Los estudios realizados hasta la fecha&#44; en los que se ha diferenciado la determinaci&#243;n de la fracci&#243;n alveolar y bronquial del FENO en pacientes con EPOC&#44; han demostrado la existencia de inflamaci&#243;n distal en algunos pacientes<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a>&#44; a semejanza de lo que ocurre en pacientes con asma grave&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En un estudio transversal realizado en nuestro pa&#237;s&#44; los niveles de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> se encontraban elevados en los pacientes definidos como ACO&#44; con un punto de corte &#243;ptimo de 20 partes por bill&#243;n &#40;ppb&#41; para el diagn&#243;stico de ACO<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Sin embargo&#44; no se han estudiado suficientemente las diferencias entre ambos componentes&#44; alveolar y bronquial&#44; as&#237; como las variables cl&#237;nicas y biol&#243;gicas que se relacionan con que la inflamaci&#243;n asiente preferentemente en uno u otro territorio&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo de este trabajo por tanto es estudiar si existen diferencias en cuanto a la cantidad de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> entre los compartimentos alveolar y bronquial en pacientes con criterios biol&#243;gicos de ACO&#44; as&#237; como si estas diferencias se asocian a otras variables cl&#237;nicas o biol&#243;gicas&#44; que puedan indicar si la inflamaci&#243;n asienta preferentemente en uno u otro territorio &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material y M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Dise&#241;o del estudio</span><p id="par0035" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; transversal&#44; enfocado a valorar las diferencias en la producci&#243;n de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> y su relaci&#243;n con variables cl&#237;nicas en pacientes con EPOC atendidos de forma consecutiva en una consulta externa de Neumolog&#237;a para la realizaci&#243;n de una exploraci&#243;n funcional completa &#40;medici&#243;n de vol&#250;menes pulmonares y difusi&#243;n&#41;&#46; El periodo de realizaci&#243;n del estudio fue de noviembre de 2014 a mayo de 2015&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Poblaci&#243;n de estudio</span><p id="par0040" class="elsevierStylePara elsevierViewall">La poblaci&#243;n de estudio estaba formada por pacientes adultos&#44; mayores de 40 a&#241;os&#44; fumadores o exfumadores con un consumo acumulado de al menos 10 a&#241;os-paquete&#44; con diagn&#243;stico de EPOC de acuerdo a las normativas y recomendaciones nacionales e internacionales<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Como criterios de exclusi&#243;n se encontraban la presencia de otra enfermedad respiratoria diferente a la EPOC que pueda alterar significativamente la exploraci&#243;n &#40;incluyendo el antecedente de asma bronquial&#41;&#44; el antecedente de exacerbaci&#243;n de la EPOC en las 4 semanas previas a la realizaci&#243;n de la prueba&#44; la incapacidad para realizar las mediciones de estudio o para contestar a los cuestionarios y la participaci&#243;n en un ensayo cl&#237;nico u otro estudio de investigaci&#243;n&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables de estudio</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables cl&#237;nicas&#58;</span> para cada paciente&#44; se recogieron datos acerca de su enfermedad respiratoria&#44; como tiempo de evoluci&#243;n&#44; h&#225;bitos t&#243;xicos&#44; comorbilidades asociadas&#44; disnea basal medida mediante la escala modificada de disnea del Medical Research Council &#40;mMRC&#41;&#44; cuestionario de s&#237;ntomas COPD Assessment Test &#40;CAT&#174;&#41;&#44; y el historial de exacerbaciones en el a&#241;o anterior &#40;clasific&#225;ndolas como moderadas en el caso de tratamiento ambulatorio con corticoides sist&#233;micos y&#47;o antibi&#243;ticos y como graves en el caso de ingreso hospitalario o estancia en un servicio de urgencias &#62;24<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Anal&#237;tica sangu&#237;nea&#58;</span> previo a la realizaci&#243;n de las pruebas de funci&#243;n respiratoria&#44; a los pacientes se les realiz&#243; una extracci&#243;n de sangre perif&#233;rica para la determinaci&#243;n del recuento de eosin&#243;filos y porcentaje de eosin&#243;filos as&#237; como para la medici&#243;n de la prote&#237;na C reactiva &#40;PCR&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Medici&#243;n del componente alveolar</span> &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; <span class="elsevierStyleItalic">y bronquial</span> &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; <span class="elsevierStyleItalic">del &#243;xido n&#237;trico en aire exhalado&#58;</span> previa a la determinaci&#243;n de la funci&#243;n pulmonar&#44; los pacientes realizaron tres maniobras de determinaci&#243;n del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> a 50<span class="elsevierStyleHsp" style=""></span>mL&#47;s &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span>&#41; y posteriormente se realizaron al menos dos determinaciones adicionales para cada flujo de 100<span class="elsevierStyleHsp" style=""></span>mL&#47;s&#44; 200<span class="elsevierStyleHsp" style=""></span>mL&#47;s y 350<span class="elsevierStyleHsp" style=""></span>mL&#47;s&#44; con el fin de poder obtener los datos de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#44; de acuerdo con las recomendaciones internacionales<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">23&#44;24</span></a>&#44; mediante un medidor de quimioluminiscencia de NO &#40;HypAir <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> &#174;&#44; Medisoft&#44; B&#233;lgica&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables de funci&#243;n pulmonar&#58;</span> los pacientes realizaron una espirometr&#237;a basal y despu&#233;s de inhalar 400<span class="elsevierStyleHsp" style=""></span>&#956;g de salbutamol de acuerdo con las recomendaciones nacionales e internacionales<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#44;26</span></a>&#46; Adem&#225;s se realiz&#243; una medici&#243;n de los vol&#250;menes pulmonares y de la capacidad de difusi&#243;n del mon&#243;xido de carbono de acuerdo con las normativas vigentes<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28</span></a>&#46; Todas las mediciones se realizaron en la misma estaci&#243;n de funci&#243;n pulmonar &#40;MasterLab&#44; Jaeger GmbH&#44; Alemania&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Aspectos &#233;ticos</span><p id="par0065" class="elsevierStylePara elsevierViewall">El estudio se realiz&#243; de acuerdo con los principios de la Declaraci&#243;n de Helsinki&#46; Los pacientes invitados a participar firmaron un consentimiento informado para su inclusi&#243;n en el mismo&#46; El estudio fue aprobado por el CEIC de referencia&#46; Todos los registros de la base de datos de pacientes que se generaron eran confidenciales y tratados de acuerdo con la Ley Org&#225;nica15&#47;1999&#44; de 13 de diciembre&#44; de Protecci&#243;n de Datos de Car&#225;cter Personal&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis estad&#237;stico</span><p id="par0070" class="elsevierStylePara elsevierViewall">Se realiz&#243; una estad&#237;stica descriptiva de las variables del estudio&#44; usando frecuencias absolutas y relativas en el caso de las variables cualitativas&#46; Las variables cuantitativas seg&#250;n sigan o no una distribuci&#243;n normal &#40;aplicando los test de normalidad adecuados al tama&#241;o muestral&#41; son resumidas mediante media&#44; desviaci&#243;n estandar &#40;Md &#177; SD&#41; y rango &#40;m&#237;nimo y m&#225;ximo&#41; o P50 &#91;P25 - P75&#93; &#40;mediana&#44; rango intercuart&#237;lico&#41; respectivamente&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La comparaci&#243;n de las variables cuantitativas seg&#250;n los grupos de estudio&#44; se efectu&#243; mediante t de Student para muestras independientes o H de Kruskal Wallis &#40;con el test apropiado dependiendo de los resultados anteriores obtenidos&#41;&#46; Se realizaron pruebas post hoc en el caso de la Anova y la U-Mann-Whitney con la correcci&#243;n de Bonferroni&#44; en el otro caso&#46; Para conocer la relaci&#243;n entre <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#44; <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> y las variables cl&#237;nicas se realiz&#243; un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple con <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> como variables dependientes&#44; respectivamente&#44; mediante el m&#233;todo de introducci&#243;n hacia delante&#46; El nivel de significaci&#243;n estad&#237;stica&#44; se estableci&#243; en p &#61; 0&#44;05&#46; El an&#225;lisis estad&#237;stico se realiz&#243; con el paquete Statistical Package for Social Sciences &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; EE&#46; UU&#46;&#41; versi&#243;n 24&#46;0&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Caracter&#237;sticas de la poblaci&#243;n de estudio</span><p id="par0080" class="elsevierStylePara elsevierViewall">Noventa y cinco pacientes fueron invitados a participar&#44; siendo finalmente 73 los pacientes en los que se pudieron completar todos los procedimientos&#46; La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra el diagrama STROBE de los participantes en el estudio&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas basales de los pacientes se exponen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En resumen&#44; se trata de una muestra de pacientes con EPOC predominantemente graves&#44; con un FEV<span class="elsevierStyleInf">1</span> medio inferior al 50&#37;&#44; fumadores activos cerca de un cuarto de la poblaci&#243;n de estudio y con una elevada carga de s&#237;ntomas y de exacerbaciones en el a&#241;o previo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra las caracter&#237;sticas de los pacientes dependiendo del criterio de recuento de eosin&#243;filos para definir ACO &#40;&#8805; 2&#37; eosin&#243;filos&#44; &#8805; 3&#37; eosin&#243;filos o &#8805; 300 c&#233;lulas&#47; &#956;L&#41;&#46; No se apreciaron diferencias en los par&#225;metros cl&#237;nicos entre los grupos dependiendo del criterio para definir ACO&#44; salvo en las mediciones de &#243;xido n&#237;trico &#40;tanto <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span> como <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46; Las <a class="elsevierStyleCrossRefs" href="#fig0010">figuras 2 y 3</a> muestran los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> respectivamente utilizando diferentes puntos de corte del recuento de eosin&#243;filos para la definici&#243;n del ACO &#40;2&#37;&#44; 3&#37; y &#62; 300 eosin&#243;filos&#44; respectivamente&#41;&#46; En todos los casos&#44; los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> eran superiores para los pacientes definidos como ACO seg&#250;n el recuento de eosin&#243;filos &#40;siendo las diferencias mayores cuando se utilizaban los criterios de &#62;3&#37; o &#62; 300 eosin&#243;filos&#41;&#46; Los niveles de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> fueron superiores solo en aquellos pacientes con ACO definido por &#62;3&#37; o &#62;300 eosin&#243;filos&#46; Utilizando criterios m&#225;s restrictivos &#40;&#62;300 eosin&#243;filos y &#62;3&#37;&#41; no mejoraba la detecci&#243;n de diferencias entre los pacientes catalogados como ACO y el resto&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Los an&#225;lisis de regresi&#243;n lineal m&#250;ltiple con el objetivo de valorar las asociaciones de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> con diferentes variables cl&#237;nicas&#44; biol&#243;gicas y de funci&#243;n pulmonar est&#225;n detallados en las <a class="elsevierStyleCrossRefs" href="#tbl0015">tablas 3 y 4</a>&#44; respectivamente&#46; Las variables que se relacionaban con la inflamaci&#243;n del territorio alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; y que predec&#237;an su valor fueron los niveles de PCR y el recuento total de eosin&#243;filos en sangre perif&#233;rica&#44; con una R<span class="elsevierStyleSup">2</span> de 0&#44;412&#46; Las variables que mayor relaci&#243;n mostraban con la inflamaci&#243;n territorio bronquial &#8211;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#8211;&#44; y que predec&#237;an su valor fueron el consumo de tabaco&#44; n&#250;mero de exacerbaciones moderadas en el a&#241;o previo&#44; y el recuento de eosin&#243;filos en sangre perif&#233;rica&#44; con una R<span class="elsevierStyleSup">2</span> del modelo de 0&#44;477&#46; En el <a class="elsevierStyleCrossRef" href="#sec0065">Anexo &#40;material adicional&#41;</a> se presentan gr&#225;ficamente los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> comparados contra los valores predichos mediante estos modelos &#40;expresado como regresiones del valor predicho estandarizado&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los resultados de este trabajo muestran que los pacientes con EPOC que cumplen uno de los criterios propuesto de ACO &#40;recuento de eosin&#243;filos en sangre perif&#233;rica elevado&#41; presentan diferencias en la producci&#243;n de &#243;xido n&#237;trico en el territorio alveolar &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; as&#237; como a nivel bronquial &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; dependiendo del dintel para considerar el recuento de eosin&#243;filos&#44; siendo similares los valores si el criterio que se aplica es el recuento de eosin&#243;filos &#8805; 300 c&#233;lulas&#47; &#956;L o el porcentaje &#8805; 3&#37;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Los hallazgos comentados est&#225;n en l&#237;nea con la experiencia publicada previamente por nuestro grupo&#44; demostrando que el <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span> puede ser un marcador accesible para la detecci&#243;n del ACO<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; a&#241;adiendo informaci&#243;n relevante con valor cl&#237;nico&#44; que matiza la aportada por la cifra de eosin&#243;filos en sangre perif&#233;rica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La medici&#243;n del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> y la determinaci&#243;n diferenciada de sus componentes alveolar y bronquial ha sido desarrollada principalmente en el campo del asma bronquial&#44; en donde se ha comprobado previamente que puede ser de utilidad a la hora de valorar el control de la enfermedad&#44; as&#237; como para la predicci&#243;n del riesgo futuro o para el ajuste de tratamiento inhalado<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">29&#8211;31</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En los pacientes con EPOC&#44; las experiencias publicadas hasta la fecha sobre las mediciones de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> han sido m&#225;s escasas y con resultados poco convincentes<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#8211;34</span></a>&#44; si bien hasta este momento no se hicieron an&#225;lisis en funci&#243;n de los criterios para definir ACO&#44; como la presencia de eosin&#243;filos en sangre perif&#233;rica&#44; o la respuesta broncodilatadora&#46; Los valores obtenidos en nuestro estudio son superponibles a la poblaci&#243;n estudiada por otros autores<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#44;33</span></a> en el grupo de pacientes sin caracter&#237;sticas biol&#243;gicas de ACO&#46; De igual modo&#44; en nuestro estudio existe una relaci&#243;n entre tabaquismo y valores bajos de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> al igual que en otro estudio&#44; sugiriendo que el tabaco influye en la producci&#243;n del &#243;xido n&#237;trico bronquial y no del alveolar&#46; Es necesario destacar que en el grupo de pacientes con EPOC que hemos estudiado&#44; no existen diferencias en cuanto a la inflamaci&#243;n del territorio alveolar y bronquial &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; en el grupo de pacientes que no presentan datos de ACO&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nuestro estudio presenta debilidades como son su naturaleza transversal&#44; el ser realizado en un &#250;nico centro y el bajo n&#250;mero de pacientes incluidos&#44; todo ello relacionado con la dificultad t&#233;cnica de realizar la determinaci&#243;n&#46; No obstante&#44; el n&#250;mero de pacientes est&#225; cercano al de otros estudios<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#46; Igualmente&#44; y en aras de eliminar posibles factores de confusi&#243;n&#44; en nuestro estudio se han excluido los pacientes previamente diagnosticados de asma bronquial&#44; por lo que los resultados obtenidos no son aplicables a la totalidad de los pacientes ACO&#46; De igual forma&#44; cabe recordar que no todos los pacientes son clasificados como ACO por el rasgo del recuento de eosin&#243;filos&#46; Otra debilidad de nuestro trabajo es la presencia de tabaquismo activo y tratamiento con CI&#44; que podr&#237;an alterar los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Desde un punto vista de la utilidad cl&#237;nica&#44; la utilizaci&#243;n de las variables incluidas en los modelos de regresi&#243;n lineal de este estudio puede ayudar al cl&#237;nico a identificar los pacientes o grupos de pacientes que pueden presentar una mayor inflamaci&#243;n Th2 a nivel bronquial o alveolar<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a>&#44; y por tanto orientar el tratamiento mediante la elecci&#243;n del sistema de inhalaci&#243;n o mol&#233;cula cuyo dep&#243;sito predominantemente a nivel bronquial o a nivel alveolar permita tratar m&#225;s espec&#237;ficamente a cada paciente&#44; disminuyendo la posibilidad de efectos secundarios<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En resumen&#44; presentamos la evidencia que muestra que la producci&#243;n de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">eNO</span> en pacientes con EPOC es diferente dependiendo de la cifra de eosin&#243;filos en sangre perif&#233;rica&#44; especialmente en lo referente a la producci&#243;n del &#243;xido n&#237;trico de las v&#237;as a&#233;reas perif&#233;ricas&#44; as&#237; como las variables cl&#237;nicas que se asocian a dicha producci&#243;n para su identificaci&#243;n sencilla por el cl&#237;nico&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Variables de estudio"
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              "titulo" => "Aspectos &#233;ticos"
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              "titulo" => "An&#225;lisis estad&#237;stico"
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    "fechaRecibido" => "2017-09-08"
    "fechaAceptado" => "2018-02-01"
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            0 => "EPOC"
            1 => "&#211;xido n&#237;trico"
            2 => "&#211;xido n&#237;trico alveolar"
            3 => "&#211;xido n&#237;trico bronquial"
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          "clase" => "keyword"
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          "palabras" => array:4 [
            0 => "COPD"
            1 => "Nitric oxide"
            2 => "Alveolar nitric oxide"
            3 => "Bronchial nitric oxide"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La medici&#243;n del &#243;xido n&#237;trico en el aire exhalado diferencia fenotipos de pacientes con EPOC del solapamiento de asma y EPOC &#40;ACO&#41;&#46; Hasta el momento no se ha estudiado si existen diferencias entre los componentes alveolar y bronquial del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> en este grupo de pacientes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional transversal realizado en consultas externas de Neumolog&#237;a&#44; incluyendo a pacientes con diagn&#243;stico de EPOC a los que se les realiz&#243; una determinaci&#243;n del &#243;xido n&#237;trico en aire exhalado &#8211; <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#8211; diferenciando en esta medida el componente alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; y el de v&#237;a a&#233;rea central &#8211;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#8211;&#44; y realizando las mediciones a distintos flujos&#46; Se compararon los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> entre los pacientes con eosinofilia &#40;definidos como aquellos pacientes con &#8805; 300 eosin&#243;filos&#47; &#956;L en sangre perif&#233;rica&#44; o bien &#8805; 2&#37; eosin&#243;filos o &#8805; 3&#37; eosin&#243;filos&#41; y se realiz&#243; un an&#225;lisis de regresi&#243;n lineal para estudiar las variables cl&#237;nicas y biol&#243;gicas que se asociaban a estas mediciones&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Participaron en el estudio 73 pacientes con EPOC&#46; Los criterios de eosinofilia utilizados se asociaban a incrementos de los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> &#40;en este &#250;ltimo caso solo los criterios &#8805; 300 eosin&#243;filos y &#8805; 3&#37; eosin&#243;filos&#41;&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> se asoci&#243; al recuento de eosin&#243;filos y PCR&#44; y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> se asoci&#243; a tabaquismo y recuento de eosin&#243;filos&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes diagnosticados de EPOC y que tienen caracter&#237;sticas de ACO muestran mayor inflamaci&#243;n a nivel bronquial y de v&#237;a a&#233;rea peque&#241;a&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> se relacionan con variables cl&#237;nicas y biol&#243;gicas&#46;</p></span>"
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            "titulo" => "M&#233;todos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Exhaled nitric oxide &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#41; measurements differentiate COPD phenotypes from asthma-COPD overlap &#40;ACO&#41;&#46; To date&#44; no study has been conducted to determine whether alveolar and bronchial components differ in this group of patients&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This was an observational cross-sectional study recruiting ambulatory COPD patients&#46; <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> was measured&#44; differentiating alveolar &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; from bronchial &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; components using a multiple-flow technique&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> values were compared between eosinophilic COPD patients &#40;defined as &#8805; 300 eosinophils&#47;&#956;L in peripheral blood test&#44; or &#8805; 2&#37; eosinophils or &#8805; 3&#37; eosinophils&#41;&#44; and a linear regression analysis was performed to determine clinical and biological variables related to these measurements&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">73 COPD patients were included in the study&#46; Eosinophil counts were associated with increased values of <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> &#40;for the latter only the association with &#8805; 300 or &#8805; 3&#37; eosinophils was significant&#41;&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> was also associated with CRP&#44; and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> with smoking&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients with COPD and ACO characteristics show increased inflammation in the large and small airways&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> are associated with clinical and biological variables&#46;</p></span>"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Valores de C<span class="elsevierStyleItalic"><span class="elsevierStyleInf">ANO</span></span> dependiendo del criterio para definir ACO&#46; a&#41; ACO definido por &#8805; 300 eosin&#243;filos&#47; &#956;L&#46; b&#41; ACO definido por &#8805; eosin&#243;filos&#46; c&#41; ACO definido por &#8805; 3&#37; eosin&#243;filos&#46; Las l&#237;neas horizontales muestran el valor medio&#44; las figuras los valores individuales observados&#44; la caja el rango IQ y los bigotes el error est&#225;ndar de la media&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">BODE&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n&#44; disnea y tolerancia al ejercicio&#59; CAT&#58; test de evaluaci&#243;n de la EPOC&#59; CI&#58; corticoides inhalados&#59; DLCO&#58; capacidad de difusi&#243;n del mon&#243;xido de carbono &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; DM&#58; diabetes mellitus&#59; FEV<span class="elsevierStyleInf">1</span>&#37; te&#243;rico&#58; flujo espiratorio m&#225;ximo en el primer segundo &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; FVC&#58; capacidad vital forzada &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; IC&#58; capacidad inspiratoria&#59; LABA&#58; agonistas &#946;-adren&#233;rgicos de acci&#243;n prolongada&#59; LAMA&#58; antagonistas muscar&#237;nicos de acci&#243;n prolongada&#59; PCR&#58; prote&#237;na C reactiva&#59; RIQ&#58; rango intercuart&#237;lico&#59; RV&#58; volumen residual &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; TLC&#58; capacidad pulmonar total &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad&#44; a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;5 &#177; 15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC&#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;2 &#177; 17&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV1&#47;FVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;7 &#177; 10&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>TLC&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#44;4 &#177; 19&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RV&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">228&#44;6 &#177; 58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IC&#47;TLC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;07 &#177; 5&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;1 &#177; 16&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gravedad &#40;BODE&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mediana &#40;RIQ&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2-5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BODE &#62;2&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;72&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Grado GOLD 2017</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD A&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD B&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;34&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD C&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD D&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;54&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Reversibilidad media&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;01 &#177; 7&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Exacerbaciones&#44; a&#241;o anterior</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbaciones moderadas&#47;a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;82 &#177; 1&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbaciones graves &#47;a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17 &#177; 0&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento habitual</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LAMA&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;93&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LABA&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;98&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CI&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 &#40;75&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;17&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;ndrome depresivo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;9&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia cardiaca&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;11&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DM tipo 2&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;8&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Indice COTE&#44; mediana &#40;RIQ&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0-6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Puntuaci&#243;n CAT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;15-27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Anal&#237;tica sangu&#237;nea</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eosin&#243;filos totales&#44; 10<span class="elsevierStyleSup">-3</span>&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;215 &#177; 0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eosin&#243;filos&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;51 &#177; 1&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCR&#44; mg&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;70 &#177; 0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrin&#243;geno&#44; mg&#47; dL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">435&#44;9 &#177; 133&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#62; 300&#47;&#956;L</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#8805; 2&#37;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#8805; 3&#37;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;1 &#177; 10&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;5 &#177; 8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;8 &#177; 8&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;6 &#177; 11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;651&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;9 &#177; 10&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;2 &#177; 13&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;921&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sexo&#44; M&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#47;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#47;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#47;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;175&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#47;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tabaquismo activo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;31&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;16&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;311&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;30&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;28&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;831&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;28&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CI&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;73&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;83&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;482&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;80&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;76&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#47;71&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEV1&#44;&#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#44;9 &#177; 16&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#44;5 &#177; 10&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;055&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;7 &#177; 11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;8 &#177; 17&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;772&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;4 &#177; 16&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#44;2 &#177; 12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respuesta BD&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;5 &#177; 7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3 &#177; 9&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;262&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;1 &#177; 9&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;9 &#177; 7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;903&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;7 &#177; 7&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;3 &#177; 9&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;494&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Exacerbaciones&#44; moderadas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;5 &#177; 1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;099&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Exacerbaciones&#44; graves&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#177; 0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;1 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#44;215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#177; 0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;054&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span>&#44; ppb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;7 &#177; 5&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;3 &#177; 8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3 &#177; 3&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;7 &#177; 7&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;2 &#177; 12&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> ppb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;2 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;8 &#177; 12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;0 &#177; 4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;5 &#177; 10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;7 &#177; 5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;5 &#177; 12&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> nL&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;0 &#177; 16&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#44;2 &#177; 15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;9 &#177; 14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;2 &#177; 18&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;0 &#177; 15&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;3 &#177; 15&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Coeficientes no estandarizados</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Coeficientes estandarizados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;059&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;897&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-15&#44;191&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8722;2&#44;573&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;895&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#44;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;379&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;8&#44;424&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;755&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;324&nbsp;\t\t\t\t\t\t\n
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Original
Óxido nítrico alveolar y bronquial en la enfermedad pulmonar obstructiva crónica y el solapamiento de asma y EPOC (ACO)
Alveolar and Bronchial Nitric Oxide in Chronic Obstructive Pulmonary Disease and Asthma-COPD Overlap
Bernardino Alcázar-Navarretea,b,c,
Corresponding author
balcazar@telefonica.net

Autor para correspondencia.
, Francisca Castellano Miñána, Pablo Santiago Díaza, Oliveiro Ruiz Rodrígueza, Pedro J. Romero Palaciosb
a AIG de Medicina, Hospital de Alta Resolución de Loja, Agencia Sanitaria Hospital de Poniente, Loja, Granada, España
b Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
c Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; se define como la presencia de limitaci&#243;n cr&#243;nica y poco reversible al flujo a&#233;reo&#44; que es habitualmente progresiva&#44; asociada a una reacci&#243;n inflamatoria an&#243;mala&#44; debida principalmente al humo del tabaco<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Esta respuesta inflamatoria caracter&#237;stica de la EPOC est&#225; mediada por macr&#243;fagos&#44; neutr&#243;filos y linfocitos T citot&#243;xicos &#40;CD8&#43;&#41;&#44; y se acompa&#241;a de cambios estructurales que pueden producir estrechamiento de la luz en las v&#237;as a&#233;reas&#44; cambios en las arterias&#44; enfisema en el par&#233;nquima pulmonar&#44; o combinaciones de estas alteraciones<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a>&#46; Estos cambios estructurales comienzan en las fases m&#225;s tempranas de la enfermedad<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a>&#44; especialmente en las v&#237;as a&#233;reas de peque&#241;o calibre&#46; En determinados pacientes&#44; esta respuesta inflamatoria est&#225; protagonizada principalmente por linfocitos Th2 y eosin&#243;filos&#44; configurando un patr&#243;n cl&#237;nico de presentaci&#243;n que comparte caracter&#237;sticas con el asma bronquial&#44; que&#44; aunque no est&#225; claramente descrito en sus caracter&#237;sticas&#44; es denominado actualmente ACO &#40;<span class="elsevierStyleItalic">Asthma-COPD overlap</span> o s&#237;ndrome de solapamiento de asma y EPOC&#41;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#8211;7</span></a>&#46; Una de las caracter&#237;sticas que diferencian biol&#243;gicamente este fenotipo en los pacientes con EPOC es el recuento de eosin&#243;filos en sangre perif&#233;rica<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a>&#44; aunque los puntos de corte &#243;ptimos no est&#225;n claramente establecidos&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La medici&#243;n del &#243;xido n&#237;trico en aire exhalado como marcador de inflamaci&#243;n en la v&#237;a a&#233;rea ha observado un gran desarrollo en las &#250;ltimas d&#233;cadas&#44; permitiendo en la actualidad&#44; mediante la aplicaci&#243;n de diferentes ecuaciones&#44; separar el componente alveolar o de la v&#237;a a&#233;rea distal &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; del componente bronquial central<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">9&#8211;11</span></a> &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46; El an&#225;lisis de ambos componentes ha sido m&#225;s extensamente estudiado en pacientes con asma bronquial&#44; en donde se aprecia un aumento del componente alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; en los pacientes con asma m&#225;s grave&#44; lo que traduce mayor inflamaci&#243;n a este nivel<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; Adem&#225;s&#44; la medici&#243;n del <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> puede ayudar a identificar a pacientes susceptibles de mejorar con el empleo de corticoides inhalados &#40;CI&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> as&#237; como a pacientes con mayor riesgo de comorbilidad<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En pacientes con EPOC&#44; la medici&#243;n del &#243;xido n&#237;trico en aire exhalado &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#41; ha demostrado ser capaz de discriminar diferentes tipos de pacientes<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">16&#44;17</span></a> y estar asociada a la presencia de eosin&#243;filos en esputo<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">18&#44;19</span></a>&#44; un hallazgo caracter&#237;stico del ACO&#46; Por otra parte&#44; los niveles de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> son un buen predictor de respuesta al empleo de CI<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;21</span></a>&#46; Los estudios realizados hasta la fecha&#44; en los que se ha diferenciado la determinaci&#243;n de la fracci&#243;n alveolar y bronquial del FENO en pacientes con EPOC&#44; han demostrado la existencia de inflamaci&#243;n distal en algunos pacientes<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a>&#44; a semejanza de lo que ocurre en pacientes con asma grave&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En un estudio transversal realizado en nuestro pa&#237;s&#44; los niveles de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> se encontraban elevados en los pacientes definidos como ACO&#44; con un punto de corte &#243;ptimo de 20 partes por bill&#243;n &#40;ppb&#41; para el diagn&#243;stico de ACO<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Sin embargo&#44; no se han estudiado suficientemente las diferencias entre ambos componentes&#44; alveolar y bronquial&#44; as&#237; como las variables cl&#237;nicas y biol&#243;gicas que se relacionan con que la inflamaci&#243;n asiente preferentemente en uno u otro territorio&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo de este trabajo por tanto es estudiar si existen diferencias en cuanto a la cantidad de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> entre los compartimentos alveolar y bronquial en pacientes con criterios biol&#243;gicos de ACO&#44; as&#237; como si estas diferencias se asocian a otras variables cl&#237;nicas o biol&#243;gicas&#44; que puedan indicar si la inflamaci&#243;n asienta preferentemente en uno u otro territorio &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material y M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Dise&#241;o del estudio</span><p id="par0035" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; transversal&#44; enfocado a valorar las diferencias en la producci&#243;n de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> y su relaci&#243;n con variables cl&#237;nicas en pacientes con EPOC atendidos de forma consecutiva en una consulta externa de Neumolog&#237;a para la realizaci&#243;n de una exploraci&#243;n funcional completa &#40;medici&#243;n de vol&#250;menes pulmonares y difusi&#243;n&#41;&#46; El periodo de realizaci&#243;n del estudio fue de noviembre de 2014 a mayo de 2015&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Poblaci&#243;n de estudio</span><p id="par0040" class="elsevierStylePara elsevierViewall">La poblaci&#243;n de estudio estaba formada por pacientes adultos&#44; mayores de 40 a&#241;os&#44; fumadores o exfumadores con un consumo acumulado de al menos 10 a&#241;os-paquete&#44; con diagn&#243;stico de EPOC de acuerdo a las normativas y recomendaciones nacionales e internacionales<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Como criterios de exclusi&#243;n se encontraban la presencia de otra enfermedad respiratoria diferente a la EPOC que pueda alterar significativamente la exploraci&#243;n &#40;incluyendo el antecedente de asma bronquial&#41;&#44; el antecedente de exacerbaci&#243;n de la EPOC en las 4 semanas previas a la realizaci&#243;n de la prueba&#44; la incapacidad para realizar las mediciones de estudio o para contestar a los cuestionarios y la participaci&#243;n en un ensayo cl&#237;nico u otro estudio de investigaci&#243;n&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables de estudio</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables cl&#237;nicas&#58;</span> para cada paciente&#44; se recogieron datos acerca de su enfermedad respiratoria&#44; como tiempo de evoluci&#243;n&#44; h&#225;bitos t&#243;xicos&#44; comorbilidades asociadas&#44; disnea basal medida mediante la escala modificada de disnea del Medical Research Council &#40;mMRC&#41;&#44; cuestionario de s&#237;ntomas COPD Assessment Test &#40;CAT&#174;&#41;&#44; y el historial de exacerbaciones en el a&#241;o anterior &#40;clasific&#225;ndolas como moderadas en el caso de tratamiento ambulatorio con corticoides sist&#233;micos y&#47;o antibi&#243;ticos y como graves en el caso de ingreso hospitalario o estancia en un servicio de urgencias &#62;24<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Anal&#237;tica sangu&#237;nea&#58;</span> previo a la realizaci&#243;n de las pruebas de funci&#243;n respiratoria&#44; a los pacientes se les realiz&#243; una extracci&#243;n de sangre perif&#233;rica para la determinaci&#243;n del recuento de eosin&#243;filos y porcentaje de eosin&#243;filos as&#237; como para la medici&#243;n de la prote&#237;na C reactiva &#40;PCR&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Medici&#243;n del componente alveolar</span> &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; <span class="elsevierStyleItalic">y bronquial</span> &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; <span class="elsevierStyleItalic">del &#243;xido n&#237;trico en aire exhalado&#58;</span> previa a la determinaci&#243;n de la funci&#243;n pulmonar&#44; los pacientes realizaron tres maniobras de determinaci&#243;n del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> a 50<span class="elsevierStyleHsp" style=""></span>mL&#47;s &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span>&#41; y posteriormente se realizaron al menos dos determinaciones adicionales para cada flujo de 100<span class="elsevierStyleHsp" style=""></span>mL&#47;s&#44; 200<span class="elsevierStyleHsp" style=""></span>mL&#47;s y 350<span class="elsevierStyleHsp" style=""></span>mL&#47;s&#44; con el fin de poder obtener los datos de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#44; de acuerdo con las recomendaciones internacionales<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">23&#44;24</span></a>&#44; mediante un medidor de quimioluminiscencia de NO &#40;HypAir <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> &#174;&#44; Medisoft&#44; B&#233;lgica&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables de funci&#243;n pulmonar&#58;</span> los pacientes realizaron una espirometr&#237;a basal y despu&#233;s de inhalar 400<span class="elsevierStyleHsp" style=""></span>&#956;g de salbutamol de acuerdo con las recomendaciones nacionales e internacionales<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#44;26</span></a>&#46; Adem&#225;s se realiz&#243; una medici&#243;n de los vol&#250;menes pulmonares y de la capacidad de difusi&#243;n del mon&#243;xido de carbono de acuerdo con las normativas vigentes<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28</span></a>&#46; Todas las mediciones se realizaron en la misma estaci&#243;n de funci&#243;n pulmonar &#40;MasterLab&#44; Jaeger GmbH&#44; Alemania&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Aspectos &#233;ticos</span><p id="par0065" class="elsevierStylePara elsevierViewall">El estudio se realiz&#243; de acuerdo con los principios de la Declaraci&#243;n de Helsinki&#46; Los pacientes invitados a participar firmaron un consentimiento informado para su inclusi&#243;n en el mismo&#46; El estudio fue aprobado por el CEIC de referencia&#46; Todos los registros de la base de datos de pacientes que se generaron eran confidenciales y tratados de acuerdo con la Ley Org&#225;nica15&#47;1999&#44; de 13 de diciembre&#44; de Protecci&#243;n de Datos de Car&#225;cter Personal&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis estad&#237;stico</span><p id="par0070" class="elsevierStylePara elsevierViewall">Se realiz&#243; una estad&#237;stica descriptiva de las variables del estudio&#44; usando frecuencias absolutas y relativas en el caso de las variables cualitativas&#46; Las variables cuantitativas seg&#250;n sigan o no una distribuci&#243;n normal &#40;aplicando los test de normalidad adecuados al tama&#241;o muestral&#41; son resumidas mediante media&#44; desviaci&#243;n estandar &#40;Md &#177; SD&#41; y rango &#40;m&#237;nimo y m&#225;ximo&#41; o P50 &#91;P25 - P75&#93; &#40;mediana&#44; rango intercuart&#237;lico&#41; respectivamente&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La comparaci&#243;n de las variables cuantitativas seg&#250;n los grupos de estudio&#44; se efectu&#243; mediante t de Student para muestras independientes o H de Kruskal Wallis &#40;con el test apropiado dependiendo de los resultados anteriores obtenidos&#41;&#46; Se realizaron pruebas post hoc en el caso de la Anova y la U-Mann-Whitney con la correcci&#243;n de Bonferroni&#44; en el otro caso&#46; Para conocer la relaci&#243;n entre <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#44; <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> y las variables cl&#237;nicas se realiz&#243; un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple con <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> como variables dependientes&#44; respectivamente&#44; mediante el m&#233;todo de introducci&#243;n hacia delante&#46; El nivel de significaci&#243;n estad&#237;stica&#44; se estableci&#243; en p &#61; 0&#44;05&#46; El an&#225;lisis estad&#237;stico se realiz&#243; con el paquete Statistical Package for Social Sciences &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; EE&#46; UU&#46;&#41; versi&#243;n 24&#46;0&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Caracter&#237;sticas de la poblaci&#243;n de estudio</span><p id="par0080" class="elsevierStylePara elsevierViewall">Noventa y cinco pacientes fueron invitados a participar&#44; siendo finalmente 73 los pacientes en los que se pudieron completar todos los procedimientos&#46; La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra el diagrama STROBE de los participantes en el estudio&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas basales de los pacientes se exponen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En resumen&#44; se trata de una muestra de pacientes con EPOC predominantemente graves&#44; con un FEV<span class="elsevierStyleInf">1</span> medio inferior al 50&#37;&#44; fumadores activos cerca de un cuarto de la poblaci&#243;n de estudio y con una elevada carga de s&#237;ntomas y de exacerbaciones en el a&#241;o previo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra las caracter&#237;sticas de los pacientes dependiendo del criterio de recuento de eosin&#243;filos para definir ACO &#40;&#8805; 2&#37; eosin&#243;filos&#44; &#8805; 3&#37; eosin&#243;filos o &#8805; 300 c&#233;lulas&#47; &#956;L&#41;&#46; No se apreciaron diferencias en los par&#225;metros cl&#237;nicos entre los grupos dependiendo del criterio para definir ACO&#44; salvo en las mediciones de &#243;xido n&#237;trico &#40;tanto <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span> como <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41;&#46; Las <a class="elsevierStyleCrossRefs" href="#fig0010">figuras 2 y 3</a> muestran los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> respectivamente utilizando diferentes puntos de corte del recuento de eosin&#243;filos para la definici&#243;n del ACO &#40;2&#37;&#44; 3&#37; y &#62; 300 eosin&#243;filos&#44; respectivamente&#41;&#46; En todos los casos&#44; los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> eran superiores para los pacientes definidos como ACO seg&#250;n el recuento de eosin&#243;filos &#40;siendo las diferencias mayores cuando se utilizaban los criterios de &#62;3&#37; o &#62; 300 eosin&#243;filos&#41;&#46; Los niveles de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> fueron superiores solo en aquellos pacientes con ACO definido por &#62;3&#37; o &#62;300 eosin&#243;filos&#46; Utilizando criterios m&#225;s restrictivos &#40;&#62;300 eosin&#243;filos y &#62;3&#37;&#41; no mejoraba la detecci&#243;n de diferencias entre los pacientes catalogados como ACO y el resto&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Los an&#225;lisis de regresi&#243;n lineal m&#250;ltiple con el objetivo de valorar las asociaciones de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> con diferentes variables cl&#237;nicas&#44; biol&#243;gicas y de funci&#243;n pulmonar est&#225;n detallados en las <a class="elsevierStyleCrossRefs" href="#tbl0015">tablas 3 y 4</a>&#44; respectivamente&#46; Las variables que se relacionaban con la inflamaci&#243;n del territorio alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; y que predec&#237;an su valor fueron los niveles de PCR y el recuento total de eosin&#243;filos en sangre perif&#233;rica&#44; con una R<span class="elsevierStyleSup">2</span> de 0&#44;412&#46; Las variables que mayor relaci&#243;n mostraban con la inflamaci&#243;n territorio bronquial &#8211;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#8211;&#44; y que predec&#237;an su valor fueron el consumo de tabaco&#44; n&#250;mero de exacerbaciones moderadas en el a&#241;o previo&#44; y el recuento de eosin&#243;filos en sangre perif&#233;rica&#44; con una R<span class="elsevierStyleSup">2</span> del modelo de 0&#44;477&#46; En el <a class="elsevierStyleCrossRef" href="#sec0065">Anexo &#40;material adicional&#41;</a> se presentan gr&#225;ficamente los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> comparados contra los valores predichos mediante estos modelos &#40;expresado como regresiones del valor predicho estandarizado&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los resultados de este trabajo muestran que los pacientes con EPOC que cumplen uno de los criterios propuesto de ACO &#40;recuento de eosin&#243;filos en sangre perif&#233;rica elevado&#41; presentan diferencias en la producci&#243;n de &#243;xido n&#237;trico en el territorio alveolar &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; as&#237; como a nivel bronquial &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; dependiendo del dintel para considerar el recuento de eosin&#243;filos&#44; siendo similares los valores si el criterio que se aplica es el recuento de eosin&#243;filos &#8805; 300 c&#233;lulas&#47; &#956;L o el porcentaje &#8805; 3&#37;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Los hallazgos comentados est&#225;n en l&#237;nea con la experiencia publicada previamente por nuestro grupo&#44; demostrando que el <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span> puede ser un marcador accesible para la detecci&#243;n del ACO<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; a&#241;adiendo informaci&#243;n relevante con valor cl&#237;nico&#44; que matiza la aportada por la cifra de eosin&#243;filos en sangre perif&#233;rica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La medici&#243;n del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> y la determinaci&#243;n diferenciada de sus componentes alveolar y bronquial ha sido desarrollada principalmente en el campo del asma bronquial&#44; en donde se ha comprobado previamente que puede ser de utilidad a la hora de valorar el control de la enfermedad&#44; as&#237; como para la predicci&#243;n del riesgo futuro o para el ajuste de tratamiento inhalado<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">29&#8211;31</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En los pacientes con EPOC&#44; las experiencias publicadas hasta la fecha sobre las mediciones de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> han sido m&#225;s escasas y con resultados poco convincentes<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#8211;34</span></a>&#44; si bien hasta este momento no se hicieron an&#225;lisis en funci&#243;n de los criterios para definir ACO&#44; como la presencia de eosin&#243;filos en sangre perif&#233;rica&#44; o la respuesta broncodilatadora&#46; Los valores obtenidos en nuestro estudio son superponibles a la poblaci&#243;n estudiada por otros autores<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#44;33</span></a> en el grupo de pacientes sin caracter&#237;sticas biol&#243;gicas de ACO&#46; De igual modo&#44; en nuestro estudio existe una relaci&#243;n entre tabaquismo y valores bajos de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> al igual que en otro estudio&#44; sugiriendo que el tabaco influye en la producci&#243;n del &#243;xido n&#237;trico bronquial y no del alveolar&#46; Es necesario destacar que en el grupo de pacientes con EPOC que hemos estudiado&#44; no existen diferencias en cuanto a la inflamaci&#243;n del territorio alveolar y bronquial &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; en el grupo de pacientes que no presentan datos de ACO&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nuestro estudio presenta debilidades como son su naturaleza transversal&#44; el ser realizado en un &#250;nico centro y el bajo n&#250;mero de pacientes incluidos&#44; todo ello relacionado con la dificultad t&#233;cnica de realizar la determinaci&#243;n&#46; No obstante&#44; el n&#250;mero de pacientes est&#225; cercano al de otros estudios<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#46; Igualmente&#44; y en aras de eliminar posibles factores de confusi&#243;n&#44; en nuestro estudio se han excluido los pacientes previamente diagnosticados de asma bronquial&#44; por lo que los resultados obtenidos no son aplicables a la totalidad de los pacientes ACO&#46; De igual forma&#44; cabe recordar que no todos los pacientes son clasificados como ACO por el rasgo del recuento de eosin&#243;filos&#46; Otra debilidad de nuestro trabajo es la presencia de tabaquismo activo y tratamiento con CI&#44; que podr&#237;an alterar los niveles de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Desde un punto vista de la utilidad cl&#237;nica&#44; la utilizaci&#243;n de las variables incluidas en los modelos de regresi&#243;n lineal de este estudio puede ayudar al cl&#237;nico a identificar los pacientes o grupos de pacientes que pueden presentar una mayor inflamaci&#243;n Th2 a nivel bronquial o alveolar<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a>&#44; y por tanto orientar el tratamiento mediante la elecci&#243;n del sistema de inhalaci&#243;n o mol&#233;cula cuyo dep&#243;sito predominantemente a nivel bronquial o a nivel alveolar permita tratar m&#225;s espec&#237;ficamente a cada paciente&#44; disminuyendo la posibilidad de efectos secundarios<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En resumen&#44; presentamos la evidencia que muestra que la producci&#243;n de <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">eNO</span> en pacientes con EPOC es diferente dependiendo de la cifra de eosin&#243;filos en sangre perif&#233;rica&#44; especialmente en lo referente a la producci&#243;n del &#243;xido n&#237;trico de las v&#237;as a&#233;reas perif&#233;ricas&#44; as&#237; como las variables cl&#237;nicas que se asocian a dicha producci&#243;n para su identificaci&#243;n sencilla por el cl&#237;nico&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Variables de estudio"
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              "titulo" => "Aspectos &#233;ticos"
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              "titulo" => "An&#225;lisis estad&#237;stico"
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              "titulo" => "Caracter&#237;sticas de la poblaci&#243;n de estudio"
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          "titulo" => "Discusi&#243;n"
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    "fechaRecibido" => "2017-09-08"
    "fechaAceptado" => "2018-02-01"
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            0 => "EPOC"
            1 => "&#211;xido n&#237;trico"
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          "clase" => "keyword"
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            0 => "COPD"
            1 => "Nitric oxide"
            2 => "Alveolar nitric oxide"
            3 => "Bronchial nitric oxide"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La medici&#243;n del &#243;xido n&#237;trico en el aire exhalado diferencia fenotipos de pacientes con EPOC del solapamiento de asma y EPOC &#40;ACO&#41;&#46; Hasta el momento no se ha estudiado si existen diferencias entre los componentes alveolar y bronquial del <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> en este grupo de pacientes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional transversal realizado en consultas externas de Neumolog&#237;a&#44; incluyendo a pacientes con diagn&#243;stico de EPOC a los que se les realiz&#243; una determinaci&#243;n del &#243;xido n&#237;trico en aire exhalado &#8211; <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#8211; diferenciando en esta medida el componente alveolar &#8211;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#8211; y el de v&#237;a a&#233;rea central &#8211;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#8211;&#44; y realizando las mediciones a distintos flujos&#46; Se compararon los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> entre los pacientes con eosinofilia &#40;definidos como aquellos pacientes con &#8805; 300 eosin&#243;filos&#47; &#956;L en sangre perif&#233;rica&#44; o bien &#8805; 2&#37; eosin&#243;filos o &#8805; 3&#37; eosin&#243;filos&#41; y se realiz&#243; un an&#225;lisis de regresi&#243;n lineal para estudiar las variables cl&#237;nicas y biol&#243;gicas que se asociaban a estas mediciones&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Participaron en el estudio 73 pacientes con EPOC&#46; Los criterios de eosinofilia utilizados se asociaban a incrementos de los valores de <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y de <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> &#40;en este &#250;ltimo caso solo los criterios &#8805; 300 eosin&#243;filos y &#8805; 3&#37; eosin&#243;filos&#41;&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> se asoci&#243; al recuento de eosin&#243;filos y PCR&#44; y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> se asoci&#243; a tabaquismo y recuento de eosin&#243;filos&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes diagnosticados de EPOC y que tienen caracter&#237;sticas de ACO muestran mayor inflamaci&#243;n a nivel bronquial y de v&#237;a a&#233;rea peque&#241;a&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> y <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> se relacionan con variables cl&#237;nicas y biol&#243;gicas&#46;</p></span>"
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          1 => array:2 [
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            "titulo" => "M&#233;todos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Exhaled nitric oxide &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span>&#41; measurements differentiate COPD phenotypes from asthma-COPD overlap &#40;ACO&#41;&#46; To date&#44; no study has been conducted to determine whether alveolar and bronchial components differ in this group of patients&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This was an observational cross-sectional study recruiting ambulatory COPD patients&#46; <span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO</span> was measured&#44; differentiating alveolar &#40;<span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span>&#41; from bronchial &#40;<span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span>&#41; components using a multiple-flow technique&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> values were compared between eosinophilic COPD patients &#40;defined as &#8805; 300 eosinophils&#47;&#956;L in peripheral blood test&#44; or &#8805; 2&#37; eosinophils or &#8805; 3&#37; eosinophils&#41;&#44; and a linear regression analysis was performed to determine clinical and biological variables related to these measurements&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">73 COPD patients were included in the study&#46; Eosinophil counts were associated with increased values of <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> &#40;for the latter only the association with &#8805; 300 or &#8805; 3&#37; eosinophils was significant&#41;&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> was also associated with CRP&#44; and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> with smoking&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients with COPD and ACO characteristics show increased inflammation in the large and small airways&#46; <span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> and <span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> are associated with clinical and biological variables&#46;</p></span>"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Valores de C<span class="elsevierStyleItalic"><span class="elsevierStyleInf">ANO</span></span> dependiendo del criterio para definir ACO&#46; a&#41; ACO definido por &#8805; 300 eosin&#243;filos&#47; &#956;L&#46; b&#41; ACO definido por &#8805; eosin&#243;filos&#46; c&#41; ACO definido por &#8805; 3&#37; eosin&#243;filos&#46; Las l&#237;neas horizontales muestran el valor medio&#44; las figuras los valores individuales observados&#44; la caja el rango IQ y los bigotes el error est&#225;ndar de la media&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">BODE&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n&#44; disnea y tolerancia al ejercicio&#59; CAT&#58; test de evaluaci&#243;n de la EPOC&#59; CI&#58; corticoides inhalados&#59; DLCO&#58; capacidad de difusi&#243;n del mon&#243;xido de carbono &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; DM&#58; diabetes mellitus&#59; FEV<span class="elsevierStyleInf">1</span>&#37; te&#243;rico&#58; flujo espiratorio m&#225;ximo en el primer segundo &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; FVC&#58; capacidad vital forzada &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; IC&#58; capacidad inspiratoria&#59; LABA&#58; agonistas &#946;-adren&#233;rgicos de acci&#243;n prolongada&#59; LAMA&#58; antagonistas muscar&#237;nicos de acci&#243;n prolongada&#59; PCR&#58; prote&#237;na C reactiva&#59; RIQ&#58; rango intercuart&#237;lico&#59; RV&#58; volumen residual &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#59; TLC&#58; capacidad pulmonar total &#40;expresado como porcentaje sobre el te&#243;rico&#41;&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valor &#40;n &#61; 73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad&#44; a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;0 &#177; 10&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;H&#47;M&#41; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#47;10 &#40;86&#44;3&#37;&#47;13&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo activo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;28&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Funci&#243;n pulmonar</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV1&#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;5 &#177; 15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC&#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;2 &#177; 17&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV1&#47;FVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;7 &#177; 10&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>TLC&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#44;4 &#177; 19&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RV&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">228&#44;6 &#177; 58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IC&#47;TLC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;07 &#177; 5&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO&#44; &#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;1 &#177; 16&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gravedad &#40;BODE&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mediana &#40;RIQ&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2-5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BODE &#62;2&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;72&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Grado GOLD 2017</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD A&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD B&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;34&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD C&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD D&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;54&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Reversibilidad media&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;01 &#177; 7&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Exacerbaciones&#44; a&#241;o anterior</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbaciones moderadas&#47;a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;82 &#177; 1&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbaciones graves &#47;a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17 &#177; 0&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento habitual</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LAMA&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;93&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LABA&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;98&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CI&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 &#40;75&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;17&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;ndrome depresivo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;9&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia cardiaca&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;11&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DM tipo 2&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;8&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Indice COTE&#44; mediana &#40;RIQ&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0-6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Puntuaci&#243;n CAT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;15-27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Anal&#237;tica sangu&#237;nea</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eosin&#243;filos totales&#44; 10<span class="elsevierStyleSup">-3</span>&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;215 &#177; 0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eosin&#243;filos&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;51 &#177; 1&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCR&#44; mg&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;70 &#177; 0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrin&#243;geno&#44; mg&#47; dL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">435&#44;9 &#177; 133&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#62; 300&#47;&#956;L</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#8805; 2&#37;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">ACO por eosin&#243;filos &#8805; 3&#37;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br>&#40;n &#61; 59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;<br>&#40;n &#61; 14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;1 &#177; 10&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;5 &#177; 8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;8 &#177; 8&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;6 &#177; 11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;651&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;9 &#177; 10&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;2 &#177; 13&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;921&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sexo&#44; M&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#47;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#47;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#47;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;175&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#47;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tabaquismo activo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;31&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;16&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;311&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;30&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;28&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;831&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;28&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CI&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;73&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;83&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;482&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;80&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;76&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#47;71&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEV1&#44;&#37; te&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#44;9 &#177; 16&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#44;5 &#177; 10&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;055&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;7 &#177; 11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;8 &#177; 17&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;772&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;4 &#177; 16&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#44;2 &#177; 12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respuesta BD&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;5 &#177; 7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3 &#177; 9&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;262&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;1 &#177; 9&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;9 &#177; 7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;903&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;7 &#177; 7&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;3 &#177; 9&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;494&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Exacerbaciones&#44; moderadas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;5 &#177; 1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;099&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4 &#177; 1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Exacerbaciones&#44; graves&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#177; 0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;1 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#44;215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#177; 0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;054&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">F</span><span class="elsevierStyleInf">ENO50</span>&#44; ppb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;7 &#177; 5&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;3 &#177; 8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3 &#177; 3&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;7 &#177; 7&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;2 &#177; 12&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">C</span><span class="elsevierStyleInf">ANO</span> ppb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;2 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;8 &#177; 12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;0 &#177; 4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;5 &#177; 10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;7 &#177; 5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;5 &#177; 12&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">J</span><span class="elsevierStyleInf">awNO</span> nL&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;0 &#177; 16&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#44;2 &#177; 15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;9 &#177; 14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;2 &#177; 18&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;0 &#177; 15&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;3 &#177; 15&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Coeficientes no estandarizados</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Coeficientes estandarizados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tolerancia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VIF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="8" align="left" valign="top">&#40;Constante&#41;<br>Tabaco<br>ICS<br>FEV1&#44;&#37;<br>DLCO&#44;&#37;<br>PCR<br>Eosin&#243;filos x10-3&#44; &#956;L<br>Ex&#46; moderadas y graves&#44; a&#241;o previo</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#44;923&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;059&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 03002896
Original language: Spanish
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