van Vliet Dillys, Essers Brigitte A, Winkens Bjorn, Heynens Jan W, Muris Jean W, Jöbsis Quirijn, Dompeling Edward
Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), 6202 AZ Maastricht, The Netherlands.
Department of Clinical Epidemiology and Medical Technology Assessment, MUMC+, 6229 HX Maastricht, The Netherlands.
J Clin Med. 2020 Feb 18;9(2):555. doi: 10.3390/jcm9020555.
Managing pediatric asthma includes optimizing both asthma control and asthma-specific quality of life (QoL). However, it is unclear to what extent asthma-specific QoL is related to asthma control or other clinical characteristics over time. The aims of this study were to assess in children longitudinally: (1) the association between asthma control and asthma-specific QoL and (2) the relationship between clinical characteristics and asthma-specific QoL. In a 12-month prospective study, asthma-specific QoL, asthma control, dynamic lung function indices, fractional exhaled nitric oxide, the occurrence of exacerbations, and the use of rescue medication were assessed every 2 months. Associations between the clinical characteristics and asthma-specific QoL were analyzed using linear mixed models. At baseline, the QoL symptom score was worse in children with asthma and concomitant chronic rhinitis compared to asthmatic children without chronic rhinitis. An improvement of asthma control was longitudinally associated with an increase in asthma-specific QoL (-value < 0.01). An increased use of β-agonists, the occurrence of wheezing episodes in the year before the study, the occurrence of an asthma exacerbation in the 2 months prior to a clinical visit, and a deterioration of lung function correlated significantly with a decrease in the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) total score (-values ≤ 0.01). Chronic rhinitis did not correlate with changes in the PAQLQ score over 1 year. The conclusion was that asthma control and asthma-specific QoL were longitudinally associated, but were not mutually interchangeable. The presence of chronic rhinitis at baseline did influence QoL symptom scores. β-agonist use and exacerbations before and during the study were inversely related to the asthma-specific QoL over time.
儿童哮喘的管理包括优化哮喘控制和哮喘特异性生活质量（QoL）。然而，哮喘特异性生活质量随时间与哮喘控制或其他临床特征之间的关联程度尚不清楚。本研究的目的是对儿童进行纵向评估：（1）哮喘控制与哮喘特异性生活质量之间的关联，以及（2）临床特征与哮喘特异性生活质量之间的关系。在一项为期12个月的前瞻性研究中，每2个月评估一次哮喘特异性生活质量、哮喘控制、动态肺功能指标、呼出一氧化氮分数、发作情况以及急救药物的使用情况。使用线性混合模型分析临床特征与哮喘特异性生活质量之间的关联。在基线时，与无慢性鼻炎的哮喘儿童相比，患有哮喘和慢性鼻炎的儿童的生活质量症状评分更差。哮喘控制的改善与哮喘特异性生活质量的提高呈纵向关联（P值<0.01）。β受体激动剂使用增加、研究前一年出现喘息发作、临床就诊前2个月出现哮喘发作以及肺功能恶化与儿童哮喘生活质量问卷（PAQLQ）总分降低显著相关（P值≤0.01）。慢性鼻炎与1年内PAQLQ评分的变化无关。结论是哮喘控制与哮喘特异性生活质量呈纵向关联，但并非相互可替代。基线时慢性鼻炎的存在确实会影响生活质量症状评分。随着时间的推移，研究期间及之前β受体激动剂的使用和发作与哮喘特异性生活质量呈负相关。
