Kilaikode Sasikumar, Shukla Prateek J, Phull Gurpreet, Jackson James H, Prue Dominique C, Martinez Claudia, Scheffey Krista, Pillai Dinesh K
Division of Pulmonary and Sleep Medicine, Children's National Health System, Washington 20010, DC, USA.
Division of Pulmonary and Sleep Medicine, MedStar Georgetown University Hospital, Washington 20007, DC, USA.
Children (Basel). 2017 Jun 28;4(7):54. doi: 10.3390/children4070054.
Up to 80% of asthmatic children may experience upper airway symptoms which are often perceived as coming from the lower airways. Currently, there are no validated questionnaires to assess upper airway contribution to pediatric asthma symptoms. The Sino-Nasal 5 (SN-5) questionnaire was previously validated for identifying radiographic confirmed sinus disease in children. In this study, we hypothesize that significant SN-5 scores (≥3.5) are associated with abnormal National Asthma Education and Prevention Program (NAEPP) based asthma impairment and control in asthmatic children. Retrospective data collected on children with asthma referred for pulmonary evaluation included age, gender, ethnicity, NAEPP asthma severity, asthma control (Test for Respiratory and Asthma Control in Kids (TRACK) < 5 years, Asthma Control Test (ACT) 5 years) and pulmonary function testing. Associations between SN-5 scores and asthma impairment and control were identified. Seventy-six children were evaluated; 38% were female with a mean age of 6.9 years. Significant SN-5 scores were associated with decreased control of daytime symptoms (odds ratio (OR): 0.16 (95% confidence interval (CI): 0.06-0.44)), night time awakenings (0.09 (0.03-0.29)), activity interference (0.2 (0.06-0.68)), NAEPP defined asthma control (0.32 (0.12-0.85)) and poor asthma control based on TRACK (p < 0.001) and ACT (p < 0.001). This suggests upper airways may play a larger role in perceived lower airway symptoms, and SN-5 may be beneficial in assessing the contribution of upper airway conditions on asthma control.
高达80%的哮喘儿童可能会出现上呼吸道症状,这些症状常被认为源自下呼吸道。目前,尚无经过验证的问卷来评估上呼吸道对儿童哮喘症状的影响。鼻-鼻窦5(SN-5)问卷先前已被验证可用于识别经影像学证实的儿童鼻窦疾病。在本研究中,我们假设显著的SN-5评分(≥3.5)与基于国家哮喘教育与预防计划(NAEPP)的哮喘损害及哮喘控制不佳相关,这些哮喘儿童接受了肺部评估,收集的回顾性数据包括年龄、性别、种族、NAEPP哮喘严重程度、哮喘控制情况(5岁以下儿童使用儿童呼吸与哮喘控制测试(TRACK),5岁及以上儿童使用哮喘控制测试(ACT))以及肺功能测试。确定了SN-5评分与哮喘损害及控制之间的关联。共评估了76名儿童;38%为女性,平均年龄6.9岁。显著的SN-5评分与日间症状控制不佳(优势比(OR):0.16(95%置信区间(CI):0.06 - 0.44))、夜间觉醒(0.09(0.03 - 0.29))、活动受限(0.2(0.06 - 0.68))、NAEPP定义的哮喘控制不佳(0.32(0.12 - 0.85))以及基于TRACK(p < 0.001)和ACT(p < 0.001)的哮喘控制不佳相关。这表明上呼吸道可能在感知到的下呼吸道症状中起更大作用,且SN-5可能有助于评估上呼吸道状况对哮喘控制的影响。