Atherton H A, White P T, Hewett G, Howells K
Dept of General Practice and Primary Care, King's College School of Medicine and Dentistry, London, UK.
Eur Respir J. 1996 Feb;9(2):232-6. doi: 10.1183/09031936.96.09020232.
Since management plans based on peak flow measurements are increasingly used, the relationship between peak flow rate and ensuing symptom frequency is of particular interest to the treatment of asthma. The objective of this study was to examine to what extent morning peak flow was related to symptom frequency during the day. In 168 out of 307 randomly selected adult asthmatics from a general practice population, adequate recordings of morning peak flow (amPF) and symptom frequency during the day (DSF) were obtained for 28 days. In each individual, the relationship between these two variables was studied and the mean values of these two variables over 28 days were calculated. The relationship between the means of the variables was also examined for the group as a whole. In individuals, the correlation between amPF and DSF varied widely; only 16% of patients had a good relationship (Pearson r = -1 to -0.5). For the whole group, the relationship between mean amPF and mean DSF best fitted a curvilinear model (r = -0.6). This was unaffected by age, sex or the use of inhaled steroids. For the majority of asthmatics, morning peak flow may be an unreliable predictor of expected symptoms during that day. Reliance on peak flow measurement as a tool enabling asthmatics to manage their asthma on a daily basis needs to be reconsidered.
由于基于峰值流速测量的管理计划越来越多地被采用，峰值流速与随后症状频率之间的关系对于哮喘治疗尤为重要。本研究的目的是探讨早晨峰值流速与白天症状频率之间的关联程度。从一个普通诊所人群中随机选取的307名成年哮喘患者中，有168名患者在28天内获得了早晨峰值流速（amPF）和白天症状频率（DSF）的充分记录。对每个个体，研究了这两个变量之间的关系，并计算了这两个变量在28天内的平均值。还对整个群体的变量均值之间的关系进行了研究。在个体中，amPF与DSF之间的相关性差异很大；只有16%的患者有良好的相关性（皮尔逊r=-1至-0.5）。对于整个群体，平均amPF与平均DSF之间的关系最符合曲线模型（r=-0.6）。这不受年龄、性别或吸入性类固醇使用情况的影响。对于大多数哮喘患者来说，早晨峰值流速可能是当天预期症状的不可靠预测指标。需要重新考虑将峰值流速测量作为一种使哮喘患者能够日常管理其哮喘的工具的依赖程度。
