Turktas Haluk, Mungan Dilsad, Uysal Mehmet Atilla, Oguzulgen Kivilcim
Gazi University, School Of Medicine, Department of Chest Diseases, Ankara, Turkey.
J Asthma. 2010 Jun;47(5):557-62. doi: 10.3109/02770901003692777.
Recent data demonstrate that control of asthma is far from optimal worldwide. The aim of this study was to evaluate the level of asthma control in tertiary health services by the use of Asthma Control Test (ACT) and to assess the factors which might influence the control of the disease.
A total of 2336 patients with asthma were recruited from 28 tertiary hospitals in the study. Asthma severity was classified by the frequency of asthma symptoms, pulmonary function tests, and medication requirements according to asthma guidelines. The level of asthma control was assessed by the Turkish version of ACT and determinants of asthma control were evaluated with medical history, physical examination, patients' and disease characteristics.
Due to missing data, 1188 subjects' records were evaluated. Nearly half of the patients (51.5%) were found to be "controlled" (ACT > or =20) and 48.5% was defined as "uncontrolled" (ACT < 20). The ratio of uncontrolled asthmatic patients was significantly higher in severe asthmatics than in mild and moderate asthmatics (p < .01). Female sex, education below secondary level, forced expiratory volume in one second (FEV(1)) value <80%, peak expiratory flow (PEF) value <80%, hospitalization/emergency department visits in the last year, and systemic steroid use were found to be significantly associated with inadequate control (p < .01).
This study demonstrated that asthma control was still inadequate in the tertiary level although overall control was better than previous reports in Turkey. Patients with severe asthma were more likely to have uncontrolled disease; worse asthma control was also associated with increased hospitalizations and emergency care admissions.
近期数据表明，全球范围内哮喘控制情况远未达到最佳状态。本研究旨在通过使用哮喘控制测试（ACT）评估三级医疗服务机构中哮喘的控制水平，并评估可能影响该疾病控制的因素。
本研究从28家三级医院招募了总共2336例哮喘患者。根据哮喘指南，通过哮喘症状频率、肺功能测试和药物需求对哮喘严重程度进行分类。采用ACT土耳其语版本评估哮喘控制水平，并通过病史、体格检查、患者及疾病特征评估哮喘控制的决定因素。
由于数据缺失，对1188名受试者的记录进行了评估。发现近一半的患者（51.5%）处于“控制良好”状态（ACT≥20），48.5%被定义为“控制不佳”（ACT<20）。重度哮喘患者中控制不佳的哮喘患者比例显著高于轻度和中度哮喘患者（p<.01）。女性、初中以下文化程度、一秒用力呼气容积（FEV₁）值<80%、呼气峰值流速（PEF）值<80%、去年住院/急诊就诊以及使用全身性类固醇与控制不佳显著相关（p<.01）。
本研究表明，尽管总体控制情况优于土耳其此前的报告，但三级医疗服务机构中的哮喘控制仍不充分。重度哮喘患者更易出现疾病控制不佳的情况；哮喘控制不佳还与住院和急诊就诊次数增加有关。
