哮喘控制测试(ACT):比较哮喘控制的临床、功能学和生物学标志物
2012/05/08
背景:哮喘控制测试(ACT)是临床用于评价哮喘控制的一个简单工具。在与一般的哮喘控制评价[包括第一秒用力呼气体积(FEV1)]比较研究中,已经证实了ACT评价的有效性。
目的:评价ACT评分与哮喘控制的临床和功能学表现及气道炎症标志物的相关性。
方法:68名于该院哮喘门诊就医的哮喘患者入选本研究,其中33名采用规律性激素吸入(ICS)治疗,35名未接受激素吸入治疗。对入选者进行ACT问卷调查,并检测以下指标:(a)沙丁胺醇治疗前后FEV1;(b)呼出气一氧化氮;(c)针对乙酰甲胆碱的支气管高反应性;(d)痰液嗜酸性粒细胞计数;(e)日间和夜间症状、沙丁胺醇急救用药、每日两次的呼气峰值流量(PEF),这些检测结果记录在为期4周的日记卡中。
结果:ACT评分与症状评分、急救用药和PEF变异性相关,但与FEV1及其可逆性、气道炎症标志物无关。不管是否有ICS治疗,后三者不能区分基于ACT判断的哮喘控制与未控制患者,
结论:作为评价当前哮喘控制情况,包括哮喘症状、急救用药和PEF变异性等,ACT评分是一个有效易行的工具。肺功能和气道炎症生物标志物与ACT评价的临床哮喘控制无关,可以作为哮喘管理的额外检测指标。
(陈欣 审校)
J Asthma. 2012 Apr;49(3):317-23. Epub 2012 Mar 9.
Asthma Control Test (ACT): Comparison with Clinical, Functional, and Biological Markers of Asthma Control.
Melosini L, Dente FL, Bacci E, Bartoli ML, Cianchetti S, Costa F, Franco AD, Malagrinò L, Novelli F, Vagaggini B, Paggiaro P.
Source
Section of Respiratory Diseases, Cardio-Thoracic and Vascular Department, University of Pisa , Pisa , Italy.
Abstract
BACKGROUND:Asthma Control Test (ACT) is a simple tool for assessing the level of asthma control in clinical practice, and it has been validated in comparison with a general clinical assessment of asthma control, including forced expiratory volume in the first second (FEV(1)).
OBJECTIVE: To evaluate the relationship between ACT score and clinical and functional findings of asthma control and biomarkers of airway inflammation.
METHODS:A total of 68 asthmatic patients observed in our asthma clinic (33 regularly treated with inhaled corticosteroids (ICS) and 35 ICS-naïve) filled ACT questionnaire and underwent the following measurements: (a) FEV(1) before and after salbutamol; (b) exhaled nitric oxide; (c) bronchial hyperresponsiveness to methacholine; (d) sputum eosinophil count; and (e) daytime and nighttime symptoms, rescue salbutamol, and twice-daily peak expiratory flow (PEF) recording on a 4-week diary card.
RESULTS:ACT score significantly correlated with symptom score, rescue medication use, and PEF variability, but not with FEV(1), FEV(1) reversibility, and markers of airway inflammation, which could not distinguish controlled from uncontrolled patients according to ACT, regardless of ICS treatment.
CONCLUSION:ACT score is a valid tool to simply assess the current level of asthma control in terms of symptoms, rescue medication use, and PEF variability. Pulmonary function and biomarkers of airway inflammation are not related to the clinical asthma control as assessed by ACT and may represent additional measurements potentially useful in asthma management.
J Asthma. 2012 Apr;49(3):317-23. Epub 2012 Mar 9.
上一篇:
成人哮喘患者上呼吸道感染发作和哮喘发作的相关性
下一篇:
无哮喘症状患者对呼吸困难的敏感性与呼气峰流速波动的关系