ACT在基层医院支气管哮喘管理中的应用

Application of bronchial asthma control test in the management of asthmatic patients

目的观察并评估哮喘控制测试(asthma control test,ACT)在基层医院支气管哮喘(简称哮喘)患者管理中的应用情况。方法选取在烟台市烟台山医院哮喘门诊定期就诊的哮喘患者181例应用ACT测试,每月1次,观察哮喘患者的控制情况及治疗的依从性。在哮喘患者应用ACT前、应用ACT6个月后测定第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%pred)和用力肺活量(FVC)、FVC占预计值百分比(FVC%pred),并同时进行ACT评分。结果每月1次坚持应用ACT181例,使用率100%:坚持规范化治疗170例,治疗依从性93.9%:症状完全控制率48.6%,部分控制率28.2%。应用ACT前FEV1%pred为51.57±17.46,ACT评分16.33±3.51。应用ACT6个月后,FEV1%pred为73.41±15.02,ACT评分22.40±3.13。治疗前与治疗后差异有统计学意义(t分别为25.651、35.536,P<0.01);ACT与FEV1具有良好相关性(r=0.80,P<0.01)。结论ACT是一种简单且可信度高评估工具,能提高患者哮喘控制率及治疗的依从性,值得在基层医院中广泛推广应用。

Objective To evaluate the application of asthma control test（ACT） in the management of patients with bronchial asthma（asthma）. Methods One hundred and eighty one asthmatic patients from asthma clinic were enrolled in the ACT trial,and ACT was performed once a month for 6 months. The ACT application rate,compliance rate and asthma control state were evaluated. FEV1 value, FEV1%pred, FVC, FVC^pred and ACT value were measured before and 6 months after treatment. Results At the end of 6 months treatment, the ACT application rate was 100% （181/181）, and the compliance rate was 93.9% （170/181）. The symptoms were controlled in 48.6% of the patients and 76.8% patients had a significant alleviation. Before treatment FEV1 % pred was 51.57 ± 17.46, and ACT scores were 16.33 ± 3.51; after 6-month treatment FEV1% pred increased to 73.41 ± 15.02 and ACT scores increased to 22.40±3.13 （both P 〈0.01）. ACT scores were correlated with FEV1% pred （ r = 0.83, P 〈0.01）. Conclusions ACT is an effective method in management of asthmatic patients, increasing the compliance of patients and facilitating the asthma control.