哮喘控制标准的比较：肺活量测定的重要性
2011/12/26
摘要
目的：在有和无肺活量检测的情况下，比较采用加拿大胸科协会（CTS）哮喘管理共识摘要和全球哮喘防治创议(GINA)指南的组成指标检测哮喘控制。
方法：从2个初级护理机构的年龄≥6岁的患者电子病历（EMRs）中提取哮喘控制相关参数。比较基于CTS和GINA标准对哮喘控制进行的分级。
结果：数据来自于93名患者的113次就诊，患者平均年龄为38.7 ± 24.8岁（6～85岁）。对于仅采用CTS症状和联合CTS症状和肺活量检测，分别有22.1%和9.7%的就诊检出哮喘完全控制（p <0.01），而对于GINA症状和联合GINA症状与肺活量检测，该比例分别为17.7%和14.1%（p =0.125）。
结论：采用GINA和CTS标准对哮喘控制进行分级时，有50%以上被至少1个量表评价为哮喘控制的患者其哮喘分级存在不一致。肺活量标准中阈值的差异是造成上述不一致的主要原因。若不能将肺活量检查作为哮喘控制的一个指标，则可能对哮喘控制估计过高，而对未来的哮喘恶化风险估计过低。
（苏楠 审校）
J Asthma. 2011 Dec;48(10):1069-75.
Comparison of asthma control criteria: importance of spirometry.
Dostaler SM, Olajos-Clow JG, Sands TW, Licskai CJ, Minard JP, Lougheed MD.
Source
Kingston General Hospital , Kingston, ON , Canada.
Abstract
AIMS：To compare the measurements of asthma control using Canadian Thoracic Society (CTS) Asthma Management Consensus Summary and Global Initiative for Asthma (GINA) guidelines composite indices with and without spirometry.
METHODS：Asthma control parameters were extracted from electronic medical records (EMRs) of patients ≥6 years old at two primary care sites. Asthma control ratings calculated according to CTS and GINA criteria were compared.
RESULTS：Data were available from 113 visits by 93 patients, aged 6-85 years (38.7 ± 24.8; mean ± SD). The proportion of visits at which individuals’ asthma was completely controlled was 22.1% for CTS symptoms only and 9.7% for CTS with spirometry (p < .01); and 17.7% versus 14.1% for GINA symptoms only versus symptoms with spirometry (p = .125).
CONCLUSIONS：Asthma control ratings using GINA and CTS criteria are discordant in more than half of the patients deemed "in control" by at least one scale. Differences in the spirometry criterion threshold are primarily responsible for this discordance. Failure to include spirometry as part of the control index consistently overestimates asthma control and may underestimate future risk of exacerbations.
J Asthma. 2011 Dec;48(10):1069-75.
目的：在有和无肺活量检测的情况下，比较采用加拿大胸科协会（CTS）哮喘管理共识摘要和全球哮喘防治创议(GINA)指南的组成指标检测哮喘控制。
方法：从2个初级护理机构的年龄≥6岁的患者电子病历（EMRs）中提取哮喘控制相关参数。比较基于CTS和GINA标准对哮喘控制进行的分级。
结果：数据来自于93名患者的113次就诊，患者平均年龄为38.7 ± 24.8岁（6～85岁）。对于仅采用CTS症状和联合CTS症状和肺活量检测，分别有22.1%和9.7%的就诊检出哮喘完全控制（p <0.01），而对于GINA症状和联合GINA症状与肺活量检测，该比例分别为17.7%和14.1%（p =0.125）。
结论：采用GINA和CTS标准对哮喘控制进行分级时，有50%以上被至少1个量表评价为哮喘控制的患者其哮喘分级存在不一致。肺活量标准中阈值的差异是造成上述不一致的主要原因。若不能将肺活量检查作为哮喘控制的一个指标，则可能对哮喘控制估计过高，而对未来的哮喘恶化风险估计过低。
（苏楠 审校）
J Asthma. 2011 Dec;48(10):1069-75.
Comparison of asthma control criteria: importance of spirometry.
Dostaler SM, Olajos-Clow JG, Sands TW, Licskai CJ, Minard JP, Lougheed MD.
Source
Kingston General Hospital , Kingston, ON , Canada.
Abstract
AIMS：To compare the measurements of asthma control using Canadian Thoracic Society (CTS) Asthma Management Consensus Summary and Global Initiative for Asthma (GINA) guidelines composite indices with and without spirometry.
METHODS：Asthma control parameters were extracted from electronic medical records (EMRs) of patients ≥6 years old at two primary care sites. Asthma control ratings calculated according to CTS and GINA criteria were compared.
RESULTS：Data were available from 113 visits by 93 patients, aged 6-85 years (38.7 ± 24.8; mean ± SD). The proportion of visits at which individuals’ asthma was completely controlled was 22.1% for CTS symptoms only and 9.7% for CTS with spirometry (p < .01); and 17.7% versus 14.1% for GINA symptoms only versus symptoms with spirometry (p = .125).
CONCLUSIONS：Asthma control ratings using GINA and CTS criteria are discordant in more than half of the patients deemed "in control" by at least one scale. Differences in the spirometry criterion threshold are primarily responsible for this discordance. Failure to include spirometry as part of the control index consistently overestimates asthma control and may underestimate future risk of exacerbations.
J Asthma. 2011 Dec;48(10):1069-75.
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当前心理症状和未来哮喘转归风险的相关性：为期12个月的前瞻性队列研究
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开发计算机化适应性测试用于评价成人哮喘患者健康相关生活质量
