哮喘联盟

   摘要
   目的：哮喘控制评估是哮喘治疗决策的关键所在。用于评估全球哮喘防治创议（GINA）定义的哮喘控制的问卷涉及了4个问题。而用于评估哮喘控制的视觉模拟量表（VAS）虽然能进行简便评分，但其与GINA定义的哮喘控制的相关性仍未被充分评估。本研究目的旨在评价VAS对于GINA定义的哮喘控制是否具有预测作用，尤其是在区分哮喘的“部分控制”与“未控制”以及“部分控制”与“控制”方面的作用。
   方法：SACRA研究是在日本国内进行的一项横断面、多中心研究，研究对象为2009年3月～8月期间诊断为哮喘并接受了哮喘治疗的患者。采用GINA问卷评估哮喘控制情况，采用VAS评估哮喘的严重程度。本研究未进行肺功能检测。
   结果：1910例内科医生对29518例哮喘患者进行登记。内科医生填写了15051份(占51.0%)问卷，患者填写了14076份(占47.7%)。可评估患者共28225例（占95.6%）。 采用VAS评估哮喘症状的严重程度对GINA定义的哮喘控制分级具有预测作用（ROC曲线下面积范围为0.704～0.837）。甄别哮喘“控制”、“部分控制”和“未控制”患者的VAS评分界限分别为1.50、 4.79和 7.19。患者和医生填写的问卷的结果有效性相似。
   结论：VAS评分可对“控制”、“部分控制”和“未控制”的哮喘患者加以甄别。对于临床上每日或常规哮喘控制的评估而言，VAS评分不失为一种简易指南。
 

（刘国梁 审校）
J Asthma. 2013 Mar 18. [Epub ahead of print]

 

Visual analogue scale as a predictor of GINA-defined asthma control. The SACRA study in Japan.

Ohta K, Bousquet PJ, Akiyama K, Adachi M, Ichinose M, Ebisawa M, Tamura G, Nagai A, Nishima S, Fukuda T,Morikawa A, Okamoto Y, Kohno Y, Saito H, Takenaka H, Grouse L, Bousquet J.

Source
National Hospital Organization, Tokyo National Hospital, Tokyo Japan, Chairman of GINA Japan Committee, Chairman of ARIA Japan Committee.

Abstract
ABSTRACT OBJECTIVE: The assessment of asthma control is pivotal to treatment decisions. A questionnaire that assesses the Global Initiative for Asthma (GINA)-defined control requires four questions. A visual analogue scale (VAS) to evaluate asthma control can be simply marked, but its correlation with GINA-defined control has been insufficiently evaluated. The purpose of this study is to evaluate whether VAS levels can predict GINA-defined asthma control with particular emphasis on the distinctions between "partly controlled" and "uncontrolled" and between "partly controlled" and "controlled" asthma.
METHODS: A cross-sectional multicenter study was carried out throughout Japan (SACRA) from March to August 2009 among patients with a diagnosis and treatment of asthma. Asthma control was studied using the GINA questionnaire and a VAS measurement of asthma severity. Pulmonary function testing was not carried out.
RESULTS: 1,910 physicians enrolled 29,518 patients with asthma. 15,051 (51.0%) questionnaires were administered by physicians; patients filled out 14,076 (47.7%) questionnaires themselves. 28,225 (95.6%) of the patients were evaluable. VAS measurement of asthma symptoms was useful in predicting levels of GINA-defined control categories (the area under the ROC curve ranging from 0.704 to 0.837). Patients with "controlled", "partly controlled" and "uncontrolled" asthma were discriminated by VAS levels (1.50, 4.79, 7.19). Similar results have been obtained with self- and physician's administered questionnaires showing the validity of results.
CONCLUSION: Measurement of VAS levels is able to discriminate between patients with "controlled", "partly controlled" and "uncontrolled" asthma. The VAS score could be a simple guide in clinical situations requiring daily or regular evaluation of asthma control.
 

J Asthma. 2013 Mar 18. [Epub ahead of print]