修订版哮喘控制问卷在胸闷变异性哮喘患者中信效度和反应度评价研究

An evaluation on reliability,validity and responsiveness of the revised edition of Asthma Control Questionnaire for patients with chest tightness variant asthma

目的评价修订版哮喘控制问卷(r-ACQ)的信度、效度及反应度。方法随机纳入2015年5月至2016年12月期间于浙江大学医学院附属第二医院就诊并符合胸闷变异性哮喘(CTVA)诊断标准的患者,纳入时完成r-ACQ量表、哮喘生活质量问卷(AQLQ)、SF-36量表评分;1个月后再次填写r-ACQ量表评分并完善整体变化评定(GRC)。结果研究共纳入CTVA患者66例。r-ACQ评分与AQLQ(n=66)的相关系数为-0.706(P<0.001),与SF-36量表(n=43)的多个维度有一定相关,包括生理功能(r=-0.655,P<0.001)、社会功能(r=-0.453,P=0.002)、精力(r=-0.407,P=0.007)等维度。量表问项总Cronbach’sα系数为0.632。症状稳定的患者中,两次r-ACQ得分提示组内相关系数(ICC)为0.959(95%CI 0.891~0.985)。症状显著好转的患者中,1个月后r-ACQ评分显著下降(Z=-4.026,P<0.001)。结论 r-ACQ量表具有良好的信度、效度及反应度,适用于CTVA患者的症状控制评估。

Objective To evaluate the clinical validity, reliability and responsiveness of the revised edition of Asthma Control Questionnaire （r-ACQ）. Methods Patients diagnosed with chest tightness variant asthma （CTVA） were randomly enrolled from the Second Affiliated Hospital of Zhejiang University School of Medicine from May 2015 to December 2016. All participants completed the r-ACQ the Asthma Quality of Life Questionnaire （AQLQ） and the MOS item short from health survey （SF-36） at enrollment. A month later, participants were reevaluated by the r-ACQand the Global Rating of Change （GRC） at follow-up visits. Results Finally, 66 patients were enrolled. The correlation coefficient between the r-ACQ and AQLQ（n=66） was -0.706 （P〈0.001）. The r-ACQscores were also associated with several dimensions of the SF-36 （n=43）, including the Role Physical （r=-0.655, P〈0.001）, the Social Function （r=-0.453, P=0.002） and the Vitality （r=-0.407, P=0.007） dimension. The Cronbach＇s alpha coefficient of all items in r-ACQwas 0.632. The intra-class correlation coefficient was 0.959 （95% confidence interval, 0.891-0.985） among patients in stable condition （n=18）. Scores of r-ACQin patients with obvious improvement in chest tightness （n=23） significantly decreased after a month （Z= -4.026, P〈0.001 ）. Conclusion The r-ACQ shows excellent clinical validity, reliability and responsiveness, thus being appropriate for symptom control assessment in CTVA patients.