Isozaki Atsushi, Kawano Yutaka, Shoda Tetsuo, Mimura Sho, Ogawa Norifumi, Noma Takeshi, Kawano Tetsuya, Nakamura Yoichi
Department of Pediatrics, Medical Center for Allergy and Immune diseases, Yokohama City Minato Red Cross Hospital.
Arerugi. 2010 Jul;59(7):822-30.
Two major convenient questionnaires of asthma control in childhood, Japanese Pediatric Asthma Control Program (JPAC) and Childhood Asthma Control Test (C-ACT) have been available in Japan. The aim of this study is to evaluate relationship of two questionnaires in terms of the changes of respiratory function and fractional nitric oxide (FENO) in each individual.
The 102 samples from patients with asthma aged 6 to 11 years old and their parents' answers for the two questionnaires at regular visits were collected. At the same time, respiratory functions and FENO were measured. The correlations of each difference of scores (+/-JPAC or +/-C-ACT), correlations of +/-JPAC or +/-C-ACT and increased ratio of respiratory functions and FENO (DeltaFENO%) were examined. We analyzed the factors that influences on respiratory functions and FENO. Moreover, the correlations of increased ratio of respiratory functions and DeltaFENO% were examined.
Changes of JPAC and C-ACT correlated with each other. (rho=0.725, p<0.0001) DeltaFENO% was influenced by medications, especially ICS. +/-JPAC weakly correlated with DeltaFEV1% and DeltaFEF25-75% and DeltaPEF%, so did C-ACT. +/-JPAC correlated most strongly with the change of DeltaFEF25-75% among the parameters of respiratory functions. (rho=0.357, p=0.0003)+/-JPAC, but not +/-C-ACT weakly correlated with DeltaFENO%. (rho=-0.2045, p=0.0401)
JPAC and C-ACT reflect the change of the respiratory function of each patient rather than those at random visit. Furthermore, JPAC may reflect FENO. In conclusion, recognition of the changes of the scores of these questionnaires may increase the utilities of the same scores obtained at a single visit. It is needed further study how to use FENO added on these questionnaires.
在日本,有两种主要的用于评估儿童哮喘控制情况的便捷问卷,即日本儿童哮喘控制项目(JPAC)和儿童哮喘控制测试(C-ACT)。本研究旨在根据个体呼吸功能和呼出气一氧化氮(FENO)的变化来评估这两种问卷之间的关系。
收集了102例6至11岁哮喘患者的样本以及他们父母在定期就诊时对这两种问卷的回答。同时,测量了呼吸功能和FENO。检查了每种问卷得分差异(±JPAC或±C-ACT)之间的相关性、±JPAC或±C-ACT与呼吸功能及FENO增加率(DeltaFENO%)之间的相关性。我们分析了影响呼吸功能和FENO的因素。此外,还检查了呼吸功能增加率与DeltaFENO%之间的相关性。
JPAC和C-ACT的变化相互关联。(rho = 0.725,p < 0.0001)DeltaFENO%受药物影响,尤其是吸入性糖皮质激素(ICS)。±JPAC与DeltaFEV1%、DeltaFEF25 - 75%和DeltaPEF%呈弱相关,C-ACT也是如此。在呼吸功能参数中,±JPAC与DeltaFEF25 - 75%的变化相关性最强。(rho = 0.357,p = 0.0003)±JPAC与DeltaFENO%呈弱相关,但±C-ACT与DeltaFENO%无此相关性。(rho = -0.2045,p = 0.0401)
JPAC和C-ACT反映的是每位患者呼吸功能的变化,而非随机就诊时的情况。此外,JPAC可能反映FENO。总之,认识到这些问卷得分的变化可能会增加单次就诊时相同得分的效用。关于如何在这些问卷中加入FENO的使用,还需要进一步研究。