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目的探讨符合我国儿童哮喘控制评估的方法。方法 2006年11月至2007年11月,采用前瞻、多中心、双盲、前后对照试验方法,在厦门、南宁、海口、青岛、成都等5个城市入选有效患儿239例(共700例次),进行为期3个月的观察评估(初诊及随诊)。记录哮喘严重程度分级、肺功能1秒用力呼气容积占预计值百分比(FEV1%)、6岁以上患儿检测峰流速(PEF),针对4～12岁患儿采用中文版儿童哮喘控制测试(C-ACT)、对7～14岁患儿采用中文版儿科哮喘生命质量调查问卷(PAQLQ)。结果中文版C-ACT信度Cronbachα值为0.8546,哮喘严重程度与FEV1%、PEF、C-ACT得分之间差异有高度显著性(P均<0.01)。哮喘控制、部分控制、未控制与FEV1%、PEF之间差异具有高度显著性(P均<0.01),C-ACT得分均值分别为24.46、21.85和15.37。ROC曲线分析得出C-ACT≤19时,为未控制;≥23时为控制,20～22为部分控制。与PAQLQ多元回归分析亦呈高度正相关。结论中文版C-ACT有良好的信度效度,可用来判断哮喘是否得到控制。

Research into the application of asthma control test in children

??ObjectiveTo compare several tools for assessing asthma control??which were used internationally and domestically??and to explorechildren’s asthma control tools complying with the domestic measurement ways. MethodsBy adopting prospective??multi-centre??double-blind and control test??239 patients ??totally 700 cases?? were studied in Xiamen??Nanning??Haikou??Qingdao??and Chengdu??and they were observed and evaluated for three months??and recorded the levels of asthma severities??lung function values ??FEV1% and PEF????the Chinese version of children Asthma Control Test ??C-ACT?? scores??the Chinese version of the Pediatric Asthma Quality of Life Questionnaire ??PAQLQ??. Results The reliability of the ACT survey??as determined by Cronbach’s α-coefficient??was 0.8546?? the FEV1% values??PEF values and C-ACT scores had very significant differences in the four levels of asthma severity respectively??P < 0.01??. The more severe the asthma was??the lower the FEV1% values??PEF values or C-ACT scores were. The percent predicted FEV1% values??percent predicted PEF values and C-ACT scores had very significant differences in the three levels of asthma control respectively. C-ACT scores of well controlled??not well controlled and very poorly controlled asthma were respectively 24.46??21.85 and 15.37. Receive operating characteristic ??ROC?? curve analyses signified that asthma was very poorly controlled when the C-ACT scores were less than or equal to 19??it was not well controlled when the C-ACT scores were 20??21??or 22??and it was very well controlled when the C-ACT scores were greater than or equal to 23. ACT scores correlated significantly with the symptoms domain??the activity domain??and the emotional domain on the PAQLQ through multi-independent linear regression. Conclusion The Chinese version of the C-ACT is found to be a reliable and valid tool for measuring asthma control.