摘要
目的通过动态肺功能测试与哮喘控制测试(asthma control test,ACT)评分对不同症状感知类型的支气管哮喘(以下简称哮喘)进行研究,探讨ACT在临床使用的准确性。方法对42例不同症状感知类型哮喘患者在动态肺功能监测前和监测期间(第14天)各进行一次ACT问卷调查。同时每天用动态肺量记录仪测定肺功能,连续监测14天,对监测前和监测期间不同症状感知类型哮喘患者的ACT评分和第一秒用力肺活量占预计值百分比(FEV1%pred)进行相关性分析。结果 42例患者ACT评分与FEV1%pred进行相关分析发现,监测前和监测期间两者均存在相关性(前:r=0.317,P<0.05;期间:r=0.360,P<0.05)。症状感知正常型哮喘患者在监测前和监测期间两次ACT评分与FEV1%pred之间均存在显著相关性(前:r=0.647,P<0.01;期间:r=0.698,P<0.01)。而迟钝型和敏感型ACT评分与FEV1%pred之间均不存在相关性,其中迟钝型(前:r=-0.453,P>0.05;期间:r=0.468,P>0.05),敏感型(前:r=0.487,P>0.05;期间:r=0.253,P>0.05)。结论 ACT是一种简易有效的评价哮喘控制的方法,与症状感知正常的哮喘患者肺功能具显著的相关性和一致性,但ACT在症状感知迟钝型和敏感型哮喘患者控制水平的测试效能和准确性较低,容易出现偏差,使用前应考虑受试者的依从性及症状感知是否正常。
Objective Patients with asthma could present various symptom perception types. Aim of the study is to investigate the characteristics of the symptom perception types of bronchial asthma by using daily spirometry and Asthma Control Test （ACT） in order to determine the accuracy ACT in clinical use. Methods A cohort of 42 asthmatics with various symptom perception types re- ceived ACT questionnaire prior to and on the 14ts day lung of function monitoring program in which portable spirometer was used for dy- namic recording for 14 days. Correlation between ACT score and lung function indices （ FEV1% pred） was analyzed. Results In all patients, the ACT score was positively correlated with FEV1 % pred prior to and during dynamic monitoring program （prior： r=0. 317; during monitoring r = 0. 360, both P 〈 0.05 ）. Asthmatics with normal symptom perception yielded positive correlation between ACT scores and FEV1% pred prior to and during monitoring program （ prior： r = 0. 647 ; during monitoring： r=0. 698, both P 〈 0. 01 ）. In contrast, there was no correlation between ACT scores and FEVt % pred in sensitive （ prior： r = - 0. 453 ; during monitoring： r = 0. 468, both P 〉 0. 05） and blunted asthmatics （prior： r = 0. 650;during monitoring： r = 0. 598,both P 〉 0. 05）, respectively. Conclusion The ACT, a simple and effective assessment of asthma control, is significantly correlated with lung function in asthmatics with normal symptom perception. However, the ACT may be not associated with asthmatics with bunted and sensitive perception. Therefore, compliance and symptom perception should be considered prior to the use of ACT.
出处
《实用医院临床杂志》
2013年第4期19-22,共4页
Practical Journal of Clinical Medicine
基金
中华医学会临床医学慢性呼吸道疾病科研专项资金资助项目(编号:07010050013)
国家十二五发展计划项目:呼吸系统疾病防治研究(编号:2012BAI05B01)
