儿童哮喘控制测试在儿童哮喘管理中的可行性

Feasability study of childhood asthma control test at childhood asthma management

目的研究儿童哮喘控制测试(C-ACT)在儿童哮喘管理中应用的可行性。方法对哮喘患儿采用问卷调查、哮喘专家评估及简易肺功能(PEF%)测定,进行C-ACT可靠性评估;C-ACT与专家评估及PEF%与C-ACT评估之间的相关性;C-ACT得分在不同PEF%之间以及C-ACT得分在专家评估水平之间的比较;检测C-ACT的效标效度。结果整个样本C-ACT的7个项目Cronbach′s(克隆巴赫)a系数为0.8008;C-ACT与专家评估、PEF%的Spearman相关系数分别为0.739、0.7768;C-ACT得分在不同PEF%、专家评估水平的患儿之间差异有统计学意义(P<0.0001);C-ACT的效标效度测量结果显示出:按病情分为缓解、间歇、轻度、中度、重度5组,各组之间C-ACT及PEF%之间差异均有统计学意义。结论C-ACT具有良好的可靠性,能较准确地反映病情的严重程度,与肺功能具有高度相关性。C-ACT可在中国推广应用,可作为儿科哮喘专科医师的一个有效评估工具。

Objective To study the feasibility of childhood asthma control test （C-ACT） at the application of the childhood asthma management. Methods Evaluation of C-ACT reliability by asthmatic children＇s questionnaires, asthma expert＇s assessments and simple pulmonary function test（peak expiratory flow-PEF% ） ;Pertinence between C-ACT and expert＇s assessments,and between PEF% and the C-ACT＇s assessments; Comparisons C-ACT scores at different PEF% , as well as at the level of expert＇s assessments;Check C-ACT＇s criterion validity. Results Seven item of Cronbach＇s a coefficient were 0. 800 8 for whole sample＇s C-ACT; C-ACT and PEF% ＇s, C-ACT and experts＇ assessments＇ Spearman coefficient were 0. 776 8 and 0. 739;there were significant differences among C-ACT scores at different PEF% , as well as at the level of expert＇s assessments（P 〈0. 000 1 ） ;The patients were seperat- ed into five group by patient＇s conditions： catabatic,intermittent, mild, moderate and severe. According to the re- sults of C-ACT＇s criterion validity tests, there were significant differences among the groups＇ C-ACT and PEF%. Conclusion C-ACT has a good reliability, can aceurately reflect the severity of the disease, and highly relate to pulmonary function. C-ACT can be promoted to pediatrie asthma speeialists as an effective assessment tool.