Melosini Lorenza, Dente Federico Lorenzo, Bacci Elena, Bartoli Maria Laura, Cianchetti Silvana, Costa Francesco, Di Franco Antonella, Malagrinò Laura, Novelli Federica, Vagaggini Barbara, Paggiaro Pierluigi
Section of Respiratory Diseases, Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy.
J Asthma. 2012 Apr;49(3):317-23. doi: 10.3109/02770903.2012.661008. Epub 2012 Mar 9.
Asthma Control Test (ACT) is a simple tool for assessing the level of asthma control in clinical practice, and it has been validated in comparison with a general clinical assessment of asthma control, including forced expiratory volume in the first second (FEV(1)).
To evaluate the relationship between ACT score and clinical and functional findings of asthma control and biomarkers of airway inflammation.
A total of 68 asthmatic patients observed in our asthma clinic (33 regularly treated with inhaled corticosteroids (ICS) and 35 ICS-naïve) filled ACT questionnaire and underwent the following measurements: (a) FEV(1) before and after salbutamol; (b) exhaled nitric oxide; (c) bronchial hyperresponsiveness to methacholine; (d) sputum eosinophil count; and (e) daytime and nighttime symptoms, rescue salbutamol, and twice-daily peak expiratory flow (PEF) recording on a 4-week diary card.
ACT score significantly correlated with symptom score, rescue medication use, and PEF variability, but not with FEV(1), FEV(1) reversibility, and markers of airway inflammation, which could not distinguish controlled from uncontrolled patients according to ACT, regardless of ICS treatment.
ACT score is a valid tool to simply assess the current level of asthma control in terms of symptoms, rescue medication use, and PEF variability. Pulmonary function and biomarkers of airway inflammation are not related to the clinical asthma control as assessed by ACT and may represent additional measurements potentially useful in asthma management.
哮喘控制测试（ACT）是临床实践中评估哮喘控制水平的一种简单工具，并且已与哮喘控制的一般临床评估（包括第一秒用力呼气量（FEV₁））进行了验证。
评估ACT评分与哮喘控制的临床和功能表现以及气道炎症生物标志物之间的关系。
在我们的哮喘诊所观察的68例哮喘患者（33例接受吸入性糖皮质激素（ICS）常规治疗，35例未使用ICS）填写了ACT问卷并进行了以下测量：（a）沙丁胺醇前后的FEV₁；（b）呼出一氧化氮；（c）对乙酰甲胆碱的支气管高反应性；（d）痰液嗜酸性粒细胞计数；以及（e）在为期4周的日记卡上记录白天和夜间症状、急救沙丁胺醇使用情况以及每日两次的呼气峰值流速（PEF）。
ACT评分与症状评分、急救药物使用情况和PEF变异性显著相关，但与FEV₁、FEV₁可逆性以及气道炎症标志物无关，无论ICS治疗情况如何，这些指标均无法根据ACT区分控制良好与控制不佳的患者。
ACT评分是一种有效的工具，可根据症状、急救药物使用情况和PEF变异性简单评估哮喘当前的控制水平。肺功能和气道炎症生物标志物与ACT评估的临床哮喘控制无关，可能代表在哮喘管理中潜在有用的额外测量指标。
