摘要
目的评价哮喘控制测试(ACT)前三项(ACT-3)与ACT在判断支气管哮喘(简称哮喘)控制水平时的一致性,以获得更为简便的哮喘控制评估方法。方法研究对象为南方医院门诊诊断为哮喘的患者102例,患者正在接受或未接受规范化哮喘治疗。所有患者完成ACT评分及肺功能检查。ACT评分≤19分定义为哮喘未控制,ACT评分≥20分定义为良好控制。分析ACT与ACT-3两者的相关性及与肺功能各指标的相关性,分析ACT与ACT-3判断哮喘未控制的价值,并通过kappa系数评价ACT-3与AcT判断的吻合度。结果入选的患者ACT-3与ACT的相关系数为0.919(P=0.000)。ACT-3、ACT分别于肺功能指标第1秒用力呼气容积(FEV。)、FEV。占预计值百分比(FEV1%pred)等肺功能指标呈正相关,相关系数差异均有统计学意义。ACT-3判断哮喘未控制的ROC曲线下面积(AUC)为0.974(P=0.000)。当ACT-3≤11分时,为最佳截断点,判断哮喘未控制的敏感性为94.52%,特异性为93.10%。ACT-3≤11分和AcT≤19分判断哮喘未控制的一致性检验:kappa系数=0.858(P:0.000)。结论ACT~3能用于评价哮喘患者控制水平,以ACT-3≤11识别哮喘未控制时与ACT≤19有极高的一致性。当ACT无法完整获取时可以考虑使用ACT-3。
Objective To investigate the value of the first 3 items of asthma control test (ACT-3) for evaluating level of asthma control. Methods ACT were administered to 102 asthma patients from Nanfang Hospital. Spirometry was also used. Uncontrolled asthma was defined as ACT≤19, and well controlled asthma was defined as ACT^20. The correlation analysis between ACT, ACT-3 and the lung funcion indexes were conducted, respectively. The property of ACT-3 for identifying the uncontrolled asthma was evaluated using receiver operator characteristic (ROC) curve. And then, the agreement between ACT-3 and ACT for identifying the uncontrolled asthma was determined using kappa coefficient. Results The coefficient of correlation between the ACT-3 and ACT was 0. 919 (P = 0. 000). Statistically significant positive correlation were observed between the ACT-3, ACT and lung funcion indexes such as forced expiratory volume in one second (FEV1), percent predicted of FEV1, respectively. The areas under the ROC curve of ACT-3 for identifying the uncontrolled asthma was 0. 974 (P = 0. 000). The optimal cutoff level of ACT-3 to discriminate between uncontrolled and well controlled asthma was 11 scores, giving 94.52% sensitivity and 93.10% specificity, respectively. Kappa coefficient showed a strong agreement between ACT-3 and ACT (kappa= 0. 858, P = 0. 000). Conclusions The ACT-3 is able to assess the level of asthma control, and there's a strong agreement between ACT-3≤11 and ACT≤19 for identifying the uncontrolled asthma. ACT-3 may be a good choice when the full ACT is not available.
出处
《国际呼吸杂志》
2012年第7期486-489,共4页
International Journal of Respiration
基金
中华医学会慢性呼吸道疾病专项基金(08020460124)
国家自然科学基金(30971328)
高等学校博士学科点专项科研基金(20094433110011)
关键词
哮喘
哮喘控制测试
一致性
Asthma
Asthma control test
Consistency