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| 文化程度对支气管哮喘患者自我评估及控制水平的影响 | |
| 引用本文： | 赵海金,蔡绍曦,佟万成,李文军,付亮. 文化程度对支气管哮喘患者自我评估及控制水平的影响[J]. 南方医科大学学报, 2008, 28(5): 715-717 |
| 作者姓名： | 赵海金 蔡绍曦 佟万成 李文军 付亮 |
| 作者单位： | 南方医科大学南方医院呼吸科;公共卫生与热带医学学院,广东,广州,510515 |
| 基金项目： | 中华医学会慢性呼吸道疾病专项基金 , 广东省名医工程研究项目 , 广东省科技厅科技计划 |
| 摘 要： | 目的 探讨文化程度对支气管哮喘患者自我评估及控制的影响.方法 研究对象为门诊初次诊断为哮喘的患者75例,以患者文化程度分为两组,包括初中及以下文化程度组(A组)46例和高中及以上文化程度组(B组)29例.所有哮喘患者支气管舒张试验阳性.控制药物均为沙美特罗联合丙酸氟替卡松干粉剂(SM／FP).按照全球哮喘防治推荐方案降阶梯治疗.在治疗第8、12及24周进行哮喘控制测试(ACT)评分和最大呼气流速日内变异率检测.根据病人对ACT问题的回答、体征及肺功能检测结果判断患者是否存在高估控制水平的情况.ACT评分19分认为已达良好控制.分析文化程度在不同治疗时期自我评估情况及控制水平的影响.结果 两组在肺功能等基础水平无显著差异.经过8周治疗,A组中ACT评分19为29例,其中11例存在高估控制水平,占24％,实际哮喘控制率为39.1％.B组中ACT评分19为17例,其中4例存在高估控制水平,实际哮喘控制率44.8％.两组实际哮喘控制率无显著差异(P0.05),自我哮喘评估也无显著差异(P0.05).经过12周治疗,A组中ACT评分19为37例,其中17例存在高估控制水平,占该组的37.0％,实际哮喘控制率为43.6％.B组中ACT评分19分的为22例,其中4例存在高估控制水平,占该组的13.8％,实际哮喘控制率为62.0％.两组实际哮喘控制率无显著差异(P0.05),但A组高估控制水平显著多于B组(P<0.05).经过24周治疗,A组中ACT评分19分的为42例,其中19例存在高估控制水平,占该组的38.7％,实际哮喘控制率50.0％.B组中ACT评分19分的为26例,其中5例存在高估控制水平,实际哮喘控制率为72.4％.B组实际哮喘控制率显著高于A组(P<0.05).A组高估控制水平显著多于A组(P<0.05).结论 文化程度可能是影响病人病情评估和哮喘控制水平的重要因素,但在治疗期间不同时期并不完全一致. |
| 关 键 词： | 哮喘 哮喘控制测试 最大呼气流速日内变异率 降阶梯治疗 文化程度 |
| 文章编号： | 1673-4254(2008)05-0715-03 |
| 修稿时间： | 2007-12-31 |
Influence of education level on self-evaluation and control of patients with bronchial asthma |
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| ZHAO Hai-jin,CAI Shan-xi,TONG Wan-heng,LI Wen-jun,FU Liang. Influence of education level on self-evaluation and control of patients with bronchial asthma[J]. Journal of Southern Medical University, 2008, 28(5): 715-717 | |
| Authors: | ZHAO Hai-jin CAI Shan-xi TONG Wan-heng LI Wen-jun FU Liang |
| Affiliation: | Department of Respiratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. zhjin@fimmu.com |
| Abstract: | OBJECTIVE: To investigate the effect of education on self-evaluation and control level in patients with bronchial asthma. METHODS: Seventy-five asthmatic patients with the initial diagnosis in line with the American Thoracic Society criteria, including 46 with junior high school education or below (group A) and 29 with senior high school education or above (group B), were asked to complete a survey to assess their symptoms and asthma attacks. Asthma control test (ACT) and peak expiratory flow rate (PEFR) evaluation were performed 8, 12 and 24 weeks after salmeterol/fluticasone therapy. Step-down treatment was administered according to GINA guidelines. The self-evaluation of the patients was assessed according to ACT score, physical signs and pulmonary function. An ACT score over 19 indicate well controlled condition. The effect of education on the self-evaluation and control level of bronchial asthma was assessed. RESULTS: The two groups had similar basal level of pulmonary function (FEV1). Eight weeks after the therapy, 29 patients in group A had ACT score over 19, including 11 with high control level; in group B, 17 had ACT score over 19, of whom 4 showed high control level. There was no significant difference between the two groups in control levels and self-evaluation (P>0.05). At 12 weeks, 37 patients in group A had ACT score over 19, with 17 having high control level; 22 patients in group B had ACT score over 19, 4 showing high control level; the two groups were similar in the control levels (P>0.05) but showed significant difference in self-evaluation (P<0.05). At the time of 24 weeks, 42 and 26 patients had ACT score over 19 in the two groups, with 19 and 5 having high control level, respectively. The two groups differed significantly in the control levels (P<0.05) and self-evaluation (P<0.05). CONCLUSION: The patients' education level may play a role in self-evaluation and control level of bronchial asthma, but its impact differs in the course of the treatment. |
| Keywords: | asthma asthma control test peak expiratory flow rate (PEFR) step-down treatment education level |
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