哮喘控制试验在患者和医务人员中应用的一致性

Outcome consistency of asthma control test used among patients, general practioners and pulmonary specialists

目的：探讨哮喘控制试验（ACT）在我国哮喘患者、非专科医生、专科医生实施的可行性和一致性.方法：对广州呼吸疾病研究所、广州市红十字会医院和民航广州医院95例支气管哮喘的门诊患者进行问卷调查,采用ACT评分表,观察患者自评、教育后自评、非专科医生和专科医生评分一致性.随访6个月,每月进行ACT评分,观察ACT评分的动态变化的一致性.结果：初诊时,患者教育前自评评分明显高于教育后自评、非专科医生和专科医生的评分（P均〈0.05）;初诊和随后的6次复诊中,患者教育后自评、非专科医生与专科医生之间的评分差异没有统计学意义,且随着复诊次数的增加,患者哮喘急性发作的次数和日内最大呼气流速（PEF）变异率逐渐减少.患者自评、非专科医师和专科医师的评分均分别与哮喘急性发作次数和日内PEF变异率呈负相关（P均〈0.05）.结论：ACT评分适用于经过适当教育的患者进行自评;患者自评、非专科医生与专科医生之间ACT评分有较好的一致性,适合于哮喘控制的长期监测和评估.

Objective： To investigate the feasibility and consistency of asthma control test （ACT） among patients themselves,general practioners and pulmonary doctors. Methods： 95 patients with asthma were recruited in outpatients department from Guangzhou Institute of Respiratory Disease, Guangzhou Red Cross Hospital and Guangzhou Civil Aviation Hospital. ACT questionnaires were used to observe the consistency of patient self- evaluation before and ＇after training, evaluation by general practioners and pulmonary doctors. All the patients took ACT once every month for 6 months in order to evaluate the consistency of dynamic change of ACT score. Result： ACT score made by patients themselves before training was significantly higher than the scores made by patients after training,by general practioners and pulmonary doctors （ P 〈 0.05 ）. No significant difference was found among the ACT scores made by patients themselves before and after training, general practioners and pulmonary doctors in the first visit and the 6 further consultations followed. As the increase in number of further consultation, acute episode of asthma frequency and daily variations of PEF decreased gradually. Patient self-evaluation, scores made by general practioners and pulmonary doctors were respectively negatively correlated with acute episode of asthma frequency and daily variations of PEF （ P 〈 0. 05 ）. Conclusion ： ACT may be used for self-evaluation by asthma patients after straining. The ACT scores made by patients themselves, general practioners and pulmonary doctors were well consistent and were suitable for long-term monitoring and evaluation of asthma control.