Boulet Louis-Philippe, Boulet Véronique, Milot Joanne
Centre de recherche de l'Hôpital Laval, Institut de cardiologie et de pneumologie de l'Université Laval, 2725 chemin Sainte-Foy, Sainte-Foy, Québec, Canada.
Chest. 2002 Dec;122(6):2217-23. doi: 10.1378/chest.122.6.2217.
Current asthma guidelines suggest a series of criteria to assess if asthma is controlled. However, there is a need to develop a simple and practical method to quantify the degree of such control, both in clinical practice and research.
This report describes a new method to quantify asthma control based on a percentage score. It also aims at comparing the percentage scores obtained with patient's self-evaluation of asthma control and a current validated Mini Asthma Quality of Life (MAQOL) questionnaire.
Forty-two subjects (25 female and 17 male patients) with asthma of different severity recruited from a tertiary center asthma clinic.
The asthma scoring method provided a percentage control for symptoms, baseline expiratory flows and, an optional parameter, for airway inflammation assessed from induced-sputum eosinophil count. These control parameters were compared to an overall assessment of asthma control by the patient (also on a 100% scale) and the score obtained from a validated MAQOL questionnaire.
Mean +/- SEM scores for symptoms, expiratory flows, and airway eosinophilia (last 2 weeks) were 87.8 +/- 1.4%, 88.6 +/- 1.8%, and 66.2 +/- 3.9%, respectively. No significant correlation was found between these three parameters (p > 0.05). The mean global asthma control score and the score estimated by the patient were 80.9 +/- 1.5% and 91.7 +/- 1.5%, respectively (not significantly different). There was a significant correlation between asthma control score (percentage) and percentage symptom score (p < 0.001), while it almost achieved significance for FEV(1) (p = 0.05). Only symptom scores correlated with the MAQOL questionnaire.
We developed a simple easy-to-use asthma control scoring system based on a percentage of optimal control. The percentage symptom score but not the global control score of this new method correlated with patient's global assessment of asthma control. This could be a simple tool that is potentially useful both for the clinician and for research purposes, to quantify global or specific aspects of asthma control.
当前哮喘指南提出了一系列评估哮喘是否得到控制的标准。然而，在临床实践和研究中，都需要开发一种简单实用的方法来量化这种控制程度。
本报告描述了一种基于百分比评分来量化哮喘控制的新方法。它还旨在比较通过患者对哮喘控制的自我评估以及当前经过验证的小型哮喘生活质量（MAQOL）问卷所获得的百分比评分。
从一家三级中心哮喘诊所招募了42名不同严重程度的哮喘患者（25名女性和17名男性）。
哮喘评分方法针对症状、基线呼气流量以及一个可选参数（根据诱导痰嗜酸性粒细胞计数评估气道炎症）给出控制百分比。将这些控制参数与患者对哮喘控制的总体评估（同样采用100%量表）以及从经过验证的MAQOL问卷获得的评分进行比较。
症状、呼气流量以及气道嗜酸性粒细胞（过去2周）的平均±标准误评分为87.8±1.4%、88.6±1.8%和66.2±3.9%， respectively。这三个参数之间未发现显著相关性（p>0.05）。哮喘总体控制评分和患者估计的评分分别为80.9±1.5%和91.7±1.5%（无显著差异）。哮喘控制评分（百分比）与症状评分百分比之间存在显著相关性（p<0.001），而对于第一秒用力呼气容积（FEV(1)）几乎达到显著水平（p = 0.05）。只有症状评分与MAQOL问卷相关。
我们基于最佳控制的百分比开发了一种简单易用的哮喘控制评分系统。这种新方法的症状评分百分比而非总体控制评分与患者对哮喘控制的总体评估相关。这可能是一种对临床医生和研究目的都潜在有用的简单工具，用于量化哮喘控制的总体或特定方面。
