Gosavi Siddharth, Nadig Pratibha, Haran Alamelu
Intern Medical Officer, Vydehi Institute of Medical Sciences & Research Centre , Bengaluru, Karnataka, India .
Professor and Head of Department, Department of Pharmacology, Vydehi Institute of Medical Sciences & Research Centre , Bengaluru, Karnataka, India .
J Clin Diagn Res. 2016 Jun;10(6):OC31-5. doi: 10.7860/JCDR/2016/18670.8052. Epub 2016 Jun 1.
In-spite of the availability of effective medications, it is observed that patients with bronchial asthma on treatment are poorly controlled. An objective evaluation of asthma control especially with respect to inflammation and the factors contributing towards poor control is crucial in obtaining relief of symptoms.
Total 50 asthmatic patients on regular medication were included in the study after obtaining written informed consent. The asthma-control was evaluated based on history, clinical symptoms, need for short-acting bronchodilators, FEVs1 and sputum eosinophil count with the help of modified MAQOL. A global score of <80% was considered as poor control. The proportion of patients under each factor, in poorly-controlled group (PC) was compared with the well-controlled group (WC). The results were analysed using descriptive statistics and unpaired student's t-test.
Of the total, 33 (66%) patients were in PC category with a mean global asthma score of 58.46 ± 2.881 vs 85.2 ± 1.19 in the WC group (34%) (p<0.05). The mean age in PC was 41.41 ± 2.413 vs 29.00 ± 2.157(p<0.05) in the WC. The mean duration of asthma was 16.76 ± 2.761 in PC vs 7.882 ± 2.065 years in WC (p<0.05). The severity score was 7.265 ± 0.4434 in PC vs 6.706 ± 0.64 in WC. Eight patients in PC and six in WC were unaware of the treatment plan. One in PC group and three in WC were unaware of technique of inhalation. One in PC group and three in WC were non-compliant. Mean sputum eosinophil count was 7.441 ± 1.081 in PC vs 5.176 ± 1.201 in WC.
MAQOL is useful in evaluating asthma-control. Sputum eosinophil count correlates with asthma-control. Duration of asthma, age and severity contributed significantly to the poor control of asthma. There is a need for an objective monitoring in asthma and the treatment strategies need to be modified accordingly.
尽管有有效的药物，但观察发现接受治疗的支气管哮喘患者控制不佳。对哮喘控制进行客观评估，尤其是关于炎症以及导致控制不佳的因素，对于缓解症状至关重要。
1）使用改良的迷你哮喘生活质量问卷（MAQOL）和痰液嗜酸性粒细胞计数来衡量哮喘控制情况；2）确定年龄、哮喘病程、严重程度、依从性、吸入技术以及哮喘行动计划的知晓情况等因素在哮喘控制中的作用。
在获得书面知情同意后，共有50名规律用药的哮喘患者纳入研究。借助改良的MAQOL，根据病史、临床症状、短效支气管扩张剂的使用需求、第一秒用力呼气容积（FEV₁）和痰液嗜酸性粒细胞计数来评估哮喘控制情况。总体评分<80%被视为控制不佳。将控制不佳组（PC）中各因素下的患者比例与控制良好组（WC）进行比较。结果采用描述性统计和非配对学生t检验进行分析。
总体中，33名（66%）患者属于PC组，其总体哮喘评分为58.46±2.881，而WC组（34%）为（85.2±1.19）（p<0.05）。PC组的平均年龄为41.41±2.413，而WC组为29.00±2.157（p<0.05）。PC组哮喘的平均病程为16.76±2.761年，而WC组为7.882±2.065年（p<0.05）。PC组的严重程度评分为7.265±0.4434，而WC组为6.706±0.64。PC组有8名患者、WC组有6名患者不了解治疗计划。PC组有1名患者、WC组有3名患者不了解吸入技术。PC组有1名患者、WC组有3名患者不依从。PC组痰液嗜酸性粒细胞平均计数为7.441±1.081，而WC组为5.176±1.201。
MAQOL有助于评估哮喘控制情况。痰液嗜酸性粒细胞计数与哮喘控制相关。哮喘病程、年龄和严重程度对哮喘控制不佳有显著影响。哮喘需要进行客观监测，治疗策略也需要相应调整。
