哮喘患儿气道高反应性、哮喘控制测试与哮喘治疗评估问卷之间的相关性评估

Evaluation of association between airway hyperresponsiveness, asthma control test, and asthma therapy assessment questionnaire in asthmatic children.

作者信息

Rapino Daniele, Attanasi Marina, Consilvio Nicola P, Scaparrotta Alessandra, Cingolani Anna, Cerasa Marzia, Mohn Angelika, Di Pillo Sabrina, Chiarelli Francesco

机构信息

Allergy and Respiratory Unit, Department of Pediatrics, G, D'Annunzio University of Chieti, Via Dei Vestini 5, Chieti 66013, Italy.

出版信息

Multidiscip Respir Med. 2013 Jul 23;8(1):48. doi: 10.1186/2049-6958-8-48.

DOI:10.1186/2049-6958-8-48

PMID:23879928

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3733674/

Abstract

BACKGROUND

Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB).

METHODS

We studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR.

RESULTS

We have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01).Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01).Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1).

CONCLUSIONS

Our results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out.

摘要

背景

实现儿童哮喘控制是一项重大挑战，否则尤其是在这个年龄段，症状感知仍较差。本研究的目的是评估哮喘控制测试（ACTTM）、哮喘治疗评估问卷（ATAQTM）与运动诱发性支气管痉挛（EIB）之间的关系。

方法

我们研究了80名哮喘儿童。通过运动诱发性支气管痉挛（巴尔克方案）评估气道高反应性（AHR）。在所有受试者中使用两份问卷评估哮喘控制情况：ACT（由儿童版ACT和ACT组成）和ATAQ。此外，评估了每位患者短效β2激动剂（SABA）的使用情况。非参数变量采用卡方检验进行比较。进行二项逻辑回归以估计两份问卷在发现AHR方面的比值比（OR）。

结果

我们发现ATAQ的敏感性和特异性分别为0.72和0.45；相反，ACT在评估AHR时的敏感性和特异性分别为0.5和0.39。根据ATAQ判定为哮喘未控制的患者与根据ACT判定为哮喘未控制的患者相比，AHR的百分比显著更高（72%对50%，p<0.01）。证实这一发现的是，向ATAQ声明哮喘未控制的患者频繁使用SABA的百分比（34%）显著高于向ACT声明哮喘未控制的组（21%）（p<0.01）。二项逻辑回归显示，根据ATAQ，一项显示哮喘未控制的测试与发生AHR的几率增加相关（OR = 3.8，p = 0.05），而与ACT无关（OR = 0.2，p = 0.1）。

结论

我们的结果表明，ATAQ比ACT能更好地反映AHR和哮喘控制情况。与根据ACT声明哮喘未控制的患者相比，根据ATAQ判定为哮喘未控制的儿童发生AHR和使用急救药物（SABA）的几率更高。然而，仅靠这两份问卷都不足以全面评估儿童哮喘控制情况，始终有必要进行功能测试并调查患者的生活方式、药物使用及其他重要数据，而这些是简单问卷无法指出的。