哮喘控制测试和呼气峰值流速：独立的儿童哮喘管理工具。

Chan M, Sitaraman S, Dosanjh A

Department of Pediatrics, University of California School of Medicine, La Jolla, California, USA.

J Asthma. 2009 Dec;46(10):1042-4. doi: 10.3109/02770900903331101.

BACKGROUND

Management of asthma reflects the complexity of the pathogenesis. According to current National Heart Lung Blood Institute (NHLBI) guidelines, asthma control can be assessed using the validated asthma control test, measures of airway function, and overall assessment of risk and quality of life. We hypothesized that the asthma control test and measures of airway function are independent tools in asthma management. We also studied whether the presence of nasal symptoms is correlated to these measures.

METHODS

Serial visits (n = 45) to a pediatric respiratory clinic in an underserved area of San Diego County with a predominantly Hispanic population were reviewed. Patients were included if they were able to perform airway function tests and had more than one provider visit. Patients with other major diseases were excluded. We determined whether uncontrolled asthmatics, defined as an Asthma Control test (ACT) score of 19 or less, had lower % predicted peak expiratory flow Measurements as a group compared to those with higher scores. In addition, the individual ACT and airway function results were analyzed. Patients with and without nasal symptoms at the time of presentation were sub-analyzed to determine differences in ACT and peak flow measurements.

RESULTS

Based on n = 45 physician visits, the mean ACT score was 21 +/- 3.3 (range 12-25) and the mean peak expiratory flow rate (PEFR) was 87.4% +/- 11 (range 65-109%). Patients with ACT scores < or = to 19 or lower (< or = 90%) PEFRs were determined not to have more nasal symptoms. The measures of ACT and peak expiratory flow were independent and not correlated.

CONCLUSIONS

Our study indicates that ACT and PEFR are distinct parameters used to manage patients in a pediatric outreach asthma clinic.

背景

哮喘的管理反映了发病机制的复杂性。根据美国国立心肺血液研究所（NHLBI）目前的指南，可使用经过验证的哮喘控制测试、气道功能测量以及风险和生活质量的综合评估来评估哮喘控制情况。我们假设哮喘控制测试和气道功能测量是哮喘管理中的独立工具。我们还研究了鼻部症状的存在是否与这些测量相关。

方法

回顾了圣地亚哥县一个服务不足地区的儿科呼吸诊所的连续就诊病例（n = 45），该地区主要为西班牙裔人口。如果患者能够进行气道功能测试且就诊次数超过一次，则纳入研究。排除患有其他重大疾病的患者。我们确定，与哮喘控制测试（ACT）得分较高的患者相比，ACT得分19分及以下的未控制哮喘患者作为一个群体，其预测呼气峰值流量测量值的百分比是否更低。此外，还分析了个体的ACT和气道功能结果。对就诊时有无鼻部症状的患者进行亚组分析，以确定ACT和峰值流量测量的差异。