C-ACT对门诊定期随访管理及辅助评价儿童哮喘控制水平的价值

VALUE OF C-ACT IN THE PERIODICAL FOLLOW-UP MANAGEMENT AND THE EVALUATION FOR CONTROL LEVEL OF CHILDHOOD ASTHMA

目的探讨儿童哮喘控制测试(C-ACT)在儿童门诊定期随访管理、辅助评价儿童哮喘控制水平中的价值。方法选取支气管哮喘病儿84例,随机分为C-ACT组、常规组,各42例。两组均按照2008年版全球哮喘防治指南要求给予基础药物治疗,C-ACT组每2周进行1次C-ACT评分,定期到门诊接受随诊,C-ACT评分≤19分及时就诊;常规组分别于治疗前、治疗1个月和3个月时行C-ACT评分,不采用C-ACT评分指导治疗。结果治疗1、3个月,C-ACT组的C-ACT评分均高于常规组(t=2.675、2.591,P<0.05);治疗3个月,C-ACT组哮喘控制分级优于常规组(Z=2.225,P<0.05),C-ACT组的第1秒用力呼气容积、呼气峰值流速占预计值百分比高于常规组(t=2.673、3.549,P<0.05);治疗1、3个月,C-ACT哮喘控制评价与医师哮喘控制分级均呈显著正相关性(r=0.850、0.786,P<0.05)。结论 C-ACT在哮喘儿童门诊定期随访管理、病情控制中有重要作用,对于治疗具有指导作用。

Objective To explore the value of childhood asthma control test（C-ACT）in the follow-up management of children’s outpatient visits and evaluation for the control level of childhood asthma. Methods Eighty-four children with bronchial asthma were randomly divided into C-ACT group（n=42）and routine group（n=42）.The two groups were treated with drug therapy in accordance with Global Initiative for Asthma（2008）.The C-ACT group was assessed with the C-ACT scoring system once every 2weeks,and received regular follow-up in outpatient department.The patients with a C-ACT score of≤19should see a doctor in time.The routine group was assessed with the C-ACT scoring system before treatment and after 1and 3months of treatment,rejecting the treatment guided by the C-ACT score. Results The C-ACT score in the C-ACT group were significantly higher than that in the routine group after 1and 3months of treatment（t=2.675,2.591;P〈0.05）.After 3months of treatment,the asthma control level in the C-ACT group was significantly better than that in the routine group（Z=2.225,P〈0.05）,and the forced expiratory volume in the first second and the percentage of peak expiratory flow rate in the predicted value were significantly higher in the C-ACT group than in the routine group（t=2.673,3.549;P〈0.05）.At months 1and 3of treatment,CACT score had a significant positive correlation with asthma control level（r=0.850,0.786;P〈0.05）. Conclusion C-ACT plays an important role in regular follow-up management and disease control in children with asthma,and can provide guidance for the treatment of childhood asthma.