Tsukioka K, Tanabe N
Niigata Allergic Disease Research Institute.
Arerugi. 2001 Jan;50(1):15-20.
To estimate the effect of treatment and for patient education, we recommend 8 weeks PFM for all asthmatics when we start their treatments. To elucidate clinical characteristics of asthmatics who stop PFM, we analyzed 311 patients (145 males aged 15-76 years and 166 females aged 17-79 years) who could measure their PEFs twice daily for more than 8 consecutive weeks. The analysis of cumulative continuation rate of PEF monitoring revealed that the patients' withdrawal rate was 19% per year. The sixty asthmatics who gave up monitoring their PEFs (group A) showed significantly younger present ages (38.8 +/- 14.2, mean +/- S.D.) and younger ages of onset of their asthma (29.8 +/- 19.6) than the other 251 asthmatics who could continue to monitor their PEFs (group B). The present ages and ages of onset of asthma of group B were 46.2 +/- 16.7 and 37.6 +/- 21.2 years, respectively. Despite no significant differences in the severity of the asthma based on both clinical symptoms and PEF between groups A and B, the asthma severity based only on the clinical symptoms of group A were significantly less than those of group B. The analysis of Cox's proportional hazards model revealed that major factors which influence patients' stopping of PFM were present age and severity of their asthma which was estimated by the patients' symptoms only, without PEF assessment. These results suggest that asthmatics whose present age is young and whose ability of perception of asthma is poor will be apt to stop PFM.
为评估治疗效果并用于患者教育,我们建议在开始治疗时,对所有哮喘患者进行8周的峰流速(PEF)监测。为阐明停止PEF监测的哮喘患者的临床特征,我们分析了311例患者(145例男性,年龄15 - 76岁;166例女性,年龄17 - 79岁),这些患者能够连续8周以上每日测量两次PEF。对PEF监测累计持续率的分析显示,患者的退出率为每年19%。放弃监测PEF的60例哮喘患者(A组)的当前年龄(38.8±14.2,均值±标准差)和哮喘发病年龄(29.8±19.6)显著低于能够继续监测PEF的其他251例哮喘患者(B组)。B组的当前年龄和哮喘发病年龄分别为46.2±16.7岁和37.6±21.2岁。尽管A组和B组在基于临床症状和PEF的哮喘严重程度方面无显著差异,但仅基于临床症状的A组哮喘严重程度显著低于B组。Cox比例风险模型分析显示,影响患者停止PEF监测的主要因素是当前年龄和仅通过患者症状评估、未进行PEF评估的哮喘严重程度。这些结果表明,当前年龄较小且哮喘感知能力较差的哮喘患者容易停止PEF监测。