华南地区哮喘患者控制感知力及影响因素分析

Investigation of the level of perceived control of asthma and the factors affecting such perception in South China

目的调查华南地区哮喘患者哮喘控制感知力(PCA)水平,探讨影响PCA水平的主要因素。方法入选我院门诊2009年3月～2010年4月就诊150例哮喘患者,年龄19～65(38.6±11.7)岁,男86例,女64例;间歇和轻度持续患者46例、中度持续49例、重度持续55例,调查其人口学特征、完成哮喘控制感知力问卷(PCAQ-6)、哮喘控制问卷(ACT)、标准化哮喘患者生活质量问卷(AQLQ(S)),并收集患者填写问卷当日肺功能检查结果、外周血、诱导痰细胞分类计数。结果我院150例符合入组条件患者均完成PCAQ-6填写及上述指标采集,PCAQ-6评分范围在10～26(18.75±3.42)分。男性(18.6±3.28)分,女性(18.95±3.6)分,显著低于国外调查水平(P<0.001)。PCA与哮喘控制水平(rp=0.377,P=0.000)及哮喘相关生活质量(rp=0.675,P=0.000)显著相关。多元线性回归分析结果示:PCA与FEV1占预计值百分比(FEV1%)及与外周血嗜中性粒细胞百分比显著正相关,而与哮喘病程(年)显著负相关。结论我国华南地区哮喘患者PCA水平低下,PCA可影响哮喘控制水平及哮喘生活质量,哮喘病程(年)及肺功能水平及外周血中性粒细胞百分比是PCA主要影响因素。

Objective To investigate the level of the patients＇ perceived control of asthma（PCA） in South China and analyze the risk factors contributing to inadequate PCA.Methods A total of 150 asthmatic out-patients consisting of 86 males and 64 females aged 19-65（38.6±11.7） years were enrolled in this investigation.The patients were asked to complete questionnaires of the demographic data,perceived control of asthma（PCAQ-6） scales,asthma control test（ACT） scales and Standard asthma-specific quality of life [AQLQ（S）] scale.The data of spirometric measurements,blood cell count and induced sputum cell count were also collected.Results All the 150 asthmatic out-patients recruited completed the questionnaires and examinations.The PCAQ-6 scores ranged from 10 to 26（18.75±3.42） in these patients（18.6±3.28 in male and 18.95±3.6 in female patients）,significantly lower than those reported in other countries（P0.001）.PCA was positively correlated to the level of asthma control（rp=0.377,P=0.000） and AQLQ（S） scores（rp=0.675,P=0.000）.Multiple linear regression showed that PCA was positively correlated to FEV1% and blood neutrophil counts,and inversely to asthma duration.Conclusions The level of the PCA appears inadequate in South China.The PCA can affect the level of asthma control and asthma-specific quality of life.The factors contributing to inadequate PCA include primarily asthma duration,lung function and blood neutrophil counts.