哮喘控制问卷在支气管哮喘患儿中的应用

目的对哮喘控制问卷(ACQ)和改良哮喘控制问卷(不计肺功能,简称ACQ6)在儿童哮喘控制评估中应用的可行性进行探讨。方法选取青岛大学医学院附属医院哮喘专家门诊确诊的哮喘患儿102例,进行肺功能测试,包括一秒钟用力呼气量占预计值百分比(FEV1%)和最大呼吸流量占预计值百分比(PEF%),并进行ACQ调查;同时根据2006《哮喘管理和预防的全球策略》的哮喘控制分级标准,对哮喘患儿进行病情界定并分为控制组、部分控制组及未控制组。对3组患儿ACQ和ACQ6得分进行比较;并以FEV1%和PEF%为分组依据,比较ACQ6得分在不同FEV1%、PEF%组间的差异,分析ACQ6得分与FEV1%和PEF%的趋同性和一致性;分别对ACQ得分、ACQ6得分、FEV1%、PEF%与专家哮喘控制评估结果进行相关性分析,以检验其相关密切程度。结果 3组哮喘患儿的ACQ和ACQ6得分比较差异有统计学意义(F=171.52、117.14,Pa<0.01);ACQ6得分在不同FEV1%、PEF%水平间差异均有统计学意义(F=69.53、76.20,Pa<0.01);ACQ6与FEV1%的Spearman相关系数为-0.818,与PEF%的Spearman相关系数为-0.862,ACQ6与PEF%的相关性较FEV1%的相关性高;ACQ得分、ACQ6得分、FEV1%及PEF%与专家评估结果的Spearman相关系数分别为0.931、0.915、-0.878和-0.882,与专家评估结果关系的密切相关程度从高到低依次为ACQ>ACQ6>PEF%>FEV1%。结论 ACQ和ACQ6对不同哮喘控制水平的患儿具有良好的鉴别能力。ACQ完全可应用于儿童哮喘控制水平的评估;在缺乏肺功能设备的基层医院,ACQ6值得推广应用。

Application of Asthma Control Questionnaire in Children with Bronchial Asthma

Objective To explore the feasibility of asthma control questionnaire(ACQ) and modified asthma control questionnaire(ACQ6) on evaluating asthma control in children. Methods One hundred and two patients with paediatric asthma who were diagnosed by experts from Pediatric Clinic of the Affiliated Hospital of Qingdao University Medical College were selected.They all accepted pulmonary function test,which included percentage of the forced expiratory volume in the first second accounting for predicted value(FEV1%) and peak expiratory flow accounting for predicted value(PEF%) individually,and ACQ investigation was performed.Meanwhile,according to Global Initiative for Asthma(GINA),GINA guide asthma control grade at 2006 experts,the control level of asthmatic children was assessed and the children were divided into 3 groups including complete control,part control and out of control.Variance analysis was adopted for differences in ACQ and ACQ6 between the 3 groups.ACQ6 scores at different FEV1% and PEF% were compared,its convergence and consistency between ACQ6 score and FEV1% as well as PEF% were analyzed according to FEV1% and PEF%.The correlation was analyzed between ACQ,ACQ6,FEV1%,PEF% and results of experts′ evaluation was analyzed to check their osculation extent. Results There was statistical significance when comparing the differences of ACQ score and ACQ6 score for asthmatic children in the 3 groups(F=171.52,117.14,Pa<0.01).ACQ6 score in different group about FEV1% and PEF% all had statistical significance(F=69.53,76.20,Pa<0.01).The Spearman correlative coefficient between ACQ6 score and FEV1% was-0.818 and the Spearman correlative coefficient with the PEF% was-0.862.The correlation between ACQ6 score and PEF% was closer than that with FEV1%.Spearman correlative coefficient and ACQ score,ACQ6 score,FEV1%,PEF% with experts′ evaluation was separately as follows:0.931,0.915,-0.878 and-0.882.The correlations with experts evaluated results sequenced from high to low were ACQ>ACQ6>PEF%>FEV1%. Conclusions ACQ and ACQ6 showed good capability to identify the different levels of asthma control in children.ACQ can be used for evaluating asthma control in children.ACQ6 is worthy application especially at grass root hospitals lacking of testing equipments for pulmonary function.