Pulmonary Department, Mainz University Hospital, Langenbeckstr. 1, 55131 Mainz, Germany.
Ann Allergy Asthma Immunol. 2011 Dec;107(6):474-9. doi: 10.1016/j.anai.2011.09.001. Epub 2011 Oct 5.
The goal of asthma treatment is to achieve and maintain current best control and reduce future risk of exacerbations and long-term morbidity.
To prospectively compare current asthma control as defined by ACQ (asthma control questionnaire) and ACT (asthma control test) criteria with the GINA (Global Initiative for Asthma) classification in treated patients in a real-life setting.
In 150 adult patients (48% male, age 46.3 ± 14.4 years., forced expiratory volume in 1 second [FEV(1)], 2.3 ± 0.9 L or 78.5 ± 21.8% pred.), asthma control was evaluated using the GINA classification as the "true" and ACQ-7, ACQ-5, and ACT as "predictor" criteria. The relationship between GINA-defined uncontrolled vs controlled/partly controlled asthma and ACQ and ACT scores was assessed with the ACQ cutpoint of ≥ 1.50 and the ACT cut-point of ≤ 19 for uncontrolled asthma.
The ACQ-7 and ACT correctly predicted GINA-defined uncontrolled asthma in 71.3% and 80.7% of patients, respectively. Sensitivity was high, with 88% for ACQ-7 and 94% for ACT, specificity was 57% and 70%, positive predictive value was 63% and 72%, and negative predictive value was 86% and 93%. Similar results were obtained using ACQ-5. ACQ-7 and ACT classified significantly more patients as having uncontrolled asthma compared with the GINA criteria (P < .001).
ACQ scores ≥ 1.50 and ACT scores ≤ 19 are suitable to indicate uncontrolled asthma. To identify GINA-defined uncontrolled asthma, cutoff points for ACQ-5 should be ≥ 1.9 and for ACT ≤ 16, at least in real-life adult patients with mostly moderate and severe asthma.
哮喘治疗的目标是实现并维持当前最佳控制水平，降低未来加重和长期发病的风险。
前瞻性比较 ACQ（哮喘控制问卷）和 ACT（哮喘控制测试）标准定义的当前哮喘控制与 GINA（全球哮喘倡议）分类在真实环境中治疗患者的情况。
在 150 名成年患者（48%为男性，年龄 46.3 ± 14.4 岁，用力呼气量 1 秒 [FEV1]，2.3 ± 0.9 L 或 78.5 ± 21.8%预测值）中，使用 GINA 分类作为“真实”标准，ACQ-7、ACQ-5 和 ACT 作为“预测”标准评估哮喘控制情况。使用 ACQ 切点≥1.50 和 ACT 切点≤19 评估 GINA 定义的未控制与控制/部分控制哮喘与 ACQ 和 ACT 评分之间的关系。
ACQ-7 和 ACT 分别正确预测了 71.3%和 80.7%患者的 GINA 定义的未控制哮喘。敏感性高，ACQ-7 为 88%，ACT 为 94%，特异性为 57%和 70%，阳性预测值为 63%和 72%，阴性预测值为 86%和 93%。使用 ACQ-5 也得到了类似的结果。与 GINA 标准相比，ACQ-7 和 ACT 分类显著将更多患者归类为未控制哮喘（P<0.001）。
ACQ 评分≥1.50 和 ACT 评分≤19 适合表明未控制哮喘。要确定 GINA 定义的未控制哮喘，ACQ-5 的截止值应为≥1.9，ACT 的截止值应为≤16，至少在现实生活中患有中重度哮喘的成年患者中是这样。
