影响重症哮喘控制的多因素相关研究及其评估

Multiple Factors that Influence Severe Asthma Control and Evaluation of Control

目的分析70例重症哮喘患者控制情况并寻求难以控制原因,评估哮喘患者生活质量。方法对70例重症哮喘患者进行为期一年的6次随访后,根据哮喘控制情况分组,并进行多因素与哮喘控制的相关分析,用哮喘生活质量问卷(AQLQ)和哮喘控制问卷(ACQ)评估生活质量。结果60例患者完成随访,达到控制16例,未达控制44例。哮喘急性加重总次数明显减少(P<0.001),鼻炎和哮喘控制显著相关(P<0.05),ACQ和AQLQ对生活质量起较好的评估作用,达到哮喘控制的患者有更好的支气管可逆性。结论重症哮喘的控制较为困难,早期干预和加强管理可以减轻严重程度,可通过改善患者鼻部症状而达到更好的哮喘控制。ACQ和AQLQ可进一步应用于临床来评估患者的生活质量。

Objective To seek the causes of difficulties in severe asthma control and evaluate the quality of life by analyzing 70 patients with severe asthma. Methods Six visits were paid to the patients during 1 year follow up. We divided the patients into two groups according to their conditions, analyzed the relationship of multiple factors in asthma control, and evaluated the quality of life by means of questionnaires of ACQ and AQLQ. Results Sixty patients completed the follow-ups,with 16 successful controls and 44 failures. The number of exacerbations significantly decreased（P 〈0. 001）and the statistics showed that the incidence of rhinitis was well correlated with the control of asthma（P 〈 0.05）. ACQ and AQLQ were useful measures in evaluating the quality of life. The asthma patients under control had better reversibility of the bronchi. Conclusion The control of severe asthma is very difficult, but early intervention and better management can reduce severity. We can achieve a better control by treating rhinitis. A wider use of ACQ and AQLQ is suggested in the evaluation of quality of life in patients with asthma.