BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills ...BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.展开更多
Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment ...Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.展开更多
目的:通过研究儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids,TRACK)和儿童哮喘控制测试(childhood asthma control test,C-ACT)与全球哮喘防治创议(global initiative for asthma,GINA)标准哮喘控制水平评...目的:通过研究儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids,TRACK)和儿童哮喘控制测试(childhood asthma control test,C-ACT)与全球哮喘防治创议(global initiative for asthma,GINA)标准哮喘控制水平评估的一致性、与哮喘儿童肺功能指标的相关性,探讨2种评分方法在儿童哮喘管理中的价值。方法:选择2020年8月至2022年3月重庆市妇幼保健院儿科门诊就诊的哮喘患儿135例为研究对象,用TRACK评分表和C-ACT评分表对相应年龄的患儿及其家长进行问卷调查,分析2种评分方法与GINA标准哮喘控制水平评估分级的一致性、与肺功能指标的相关性,并比较不同评分结果组肺功能指标差异。结果:TRACK评分、C-ACT评分与GINA哮喘控制水平分级一致性检验Kappa值分别为0.517和0.531,均显示一致性一般;TRACK评分与TPF%TE和VPF%VE存在显著的正相关,但TRACK评分、C-ACT评分与FEV1%均没有显著性相关;不同TRACK评分组哮喘患儿的FEV1%差异无统计学意义(F=2.054,P=0.134),但多重比较发现≥80分组与<60分组FEV1%的差异有统计学意义(P=0.048);不同TRACK评分组哮喘患儿的TPTEF/TE(%)(F=3.171,P=0.044)和VPEF/VE(%)(F=3.919,P=0.022)差异有统计学意义,进一步多重比较发现其差异主要来自于≥80分组与60~80分组,其中VPEF/VE(%)(P=0.017)的组间差异较TPTEF/TE(%)(P=0.030)更为明显;比较不同C-ACT评分组哮喘患儿的FEV1%差异无统计学意义(F=1.756,P=0.182)。结论:TRACK评分能更好反映儿童肺功能的差异,可作为5岁以下儿童哮喘管理的一个有效评估工具。展开更多
目的探讨改良中文版儿童呼吸和哮喘控制测试(Test for Respiratory and Asthma Control in Kids Chinese Version,TRACK-C)在0~3岁哮喘婴幼儿不同患病时期的应用价值。方法选取2017年8月—2023年1月空军军医大学唐都医院小儿哮喘门诊中...目的探讨改良中文版儿童呼吸和哮喘控制测试(Test for Respiratory and Asthma Control in Kids Chinese Version,TRACK-C)在0~3岁哮喘婴幼儿不同患病时期的应用价值。方法选取2017年8月—2023年1月空军军医大学唐都医院小儿哮喘门诊中已建立标准化电子病历的203名0~3岁哮喘患儿作为哮喘组,同期100名健康儿童作为对照组。比较各组的TRACK-C评分、潮气肺功能、呼出气一氧化氮(Fractional Exhaled Nitric Oxide,FeNO)水平并进行相关性分析。结果哮喘组的FeNO、呼吸频率(Respiratory Rate,RR)和血液IgE水平高于对照组,达峰值时间比(Time to Peak Expirtory Flow/Time of Expiratory,TPTEF/TE)、达峰容积比(Volume to Peak Expiratory Flow/Volume of Expiratory,VPEF/VE)、公斤潮气量(Tidal Volume/kg,VT/KG)、TRACK-C评分水平低于对照组,差异有统计学意义(P均<0.05)。哮喘组急性期FeNO水平、RR水平高于缓解期,且TPTEF/TE、VPEF/VE、VT/KG、TRACK-C评分水平低于缓解期,差异有统计学意义(P均<0.05)。采用Pearson分析哮喘不同患病时期与各项观察指标的相关性,结果显示哮喘不同患病时期与TPTEF/TE、VPEF/VE、TRACK-C评分呈负相关(r=-0.468、-0.452、-0.289,P均<0.05)。结论TRACK-C评分可充分应用于0~3岁哮喘幼儿的病情评估,与潮气肺功能结合可以更好地对低龄患儿进行哮喘管理。展开更多
目的探讨奥马珠单抗治疗儿童过敏性哮喘的临床疗效。方法选取2021年8月至2022年3月首都医科大学附属北京儿童医院过敏反应科确诊为过敏性哮喘并应用奥马珠单抗治疗的患儿。根据治疗有效性全球评估(global evaluation of treatment effec...目的探讨奥马珠单抗治疗儿童过敏性哮喘的临床疗效。方法选取2021年8月至2022年3月首都医科大学附属北京儿童医院过敏反应科确诊为过敏性哮喘并应用奥马珠单抗治疗的患儿。根据治疗有效性全球评估(global evaluation of treatment effectiveness,GETE)分析患儿治疗16周时的临床疗效,并观察治疗4周和16周时儿童哮喘控制测试(childhood asthma control test/asthma control test,c-ACT/ACT)得分,哮喘和鼻炎视觉模拟评分(visual analogue scale,VAS),哮喘生活质量调查问卷(mini Asthma Quality of Life Questionnaire,mini-AQLQ)得分,每日激素剂量,血清总IgE、肺功能和呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)情况。结果共纳入35例患儿,其中77.1%的患儿在治疗16周时对奥马珠单抗有“极好”或“好”的应答。与治疗前相比,治疗4周和16周时患儿的c-ACT/ACT得分均升高[25.0(20.3,26.8)分,24.5(21.5,27.0)分比23.0(18.0,23.0)分;23.5(21.3,24.8)分,24.5(24.0,25.0)分比22.0(18.0,24.8)分],哮喘VAS[1.0(0.0,2.8)分,1.0(0.0,1.0)分比2.3(0.6,6.3)分]和鼻炎VAS[1.0(0.0,4.8)分,1.4(0.1,3.0)分比4.7(2.1,5.9)分]均下降,哮喘mini-AQLQ评分均升高[98.5(93.0,103.0)分,103.0(98.5,103.8)分比91.0(83.3,96.5)分],差异均有统计学意义(P<0.05)。与治疗前相比,治疗16周时患儿的每日激素剂量下降[100.0(71.0,150.0)μg比160.0(125.0,200.0)μg]、血清总IgE明显升高[1593.0(1131.0,2367.0)kU/L比684.0(331.0,1489.0)kU/L],差异均有统计学意义(P=0.000)。与治疗前相比,治疗16周时患儿肺功能指标无明显改善,差异均无统计学意义(P>0.05),但FeNO显著降低,差异有统计学意义(P<0.05)。结论在过敏性哮喘儿童中应用奥马珠单抗,可以减少患儿临床症状和糖皮质激素的剂量,改善患儿生活质量。展开更多
目的调查门诊哮喘患者控制水平的现状以及初步哮喘管理对于提高哮喘控制水平的可能获益。方法选择2011年7月到2011年9月间在我科门诊就诊的哮喘患者,评估其控制水平和其他临床特征。结果共有198例患者完成评测,管理不依从组117例,依从...目的调查门诊哮喘患者控制水平的现状以及初步哮喘管理对于提高哮喘控制水平的可能获益。方法选择2011年7月到2011年9月间在我科门诊就诊的哮喘患者,评估其控制水平和其他临床特征。结果共有198例患者完成评测,管理不依从组117例,依从组81例;整体哮喘控制测试(asthma control test,ACT)评分(18.08±4.67)分,6.57%的患者ACT得分25分;依从管理组患者哮喘控制水平、治疗依从性、急性加重的频率和患者比例等均显著优于不依从管理的患者,而两组间患者对卫生经济负担的负担能力相当。结论门诊哮喘患者控制率低,初步实施哮喘管理即可显著提高患者哮喘控制水平。展开更多
基金Supported by Science and Technology Research Project of Songjiang District,No.2020SJ340.
文摘BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.
文摘Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.
文摘目的:通过研究儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids,TRACK)和儿童哮喘控制测试(childhood asthma control test,C-ACT)与全球哮喘防治创议(global initiative for asthma,GINA)标准哮喘控制水平评估的一致性、与哮喘儿童肺功能指标的相关性,探讨2种评分方法在儿童哮喘管理中的价值。方法:选择2020年8月至2022年3月重庆市妇幼保健院儿科门诊就诊的哮喘患儿135例为研究对象,用TRACK评分表和C-ACT评分表对相应年龄的患儿及其家长进行问卷调查,分析2种评分方法与GINA标准哮喘控制水平评估分级的一致性、与肺功能指标的相关性,并比较不同评分结果组肺功能指标差异。结果:TRACK评分、C-ACT评分与GINA哮喘控制水平分级一致性检验Kappa值分别为0.517和0.531,均显示一致性一般;TRACK评分与TPF%TE和VPF%VE存在显著的正相关,但TRACK评分、C-ACT评分与FEV1%均没有显著性相关;不同TRACK评分组哮喘患儿的FEV1%差异无统计学意义(F=2.054,P=0.134),但多重比较发现≥80分组与<60分组FEV1%的差异有统计学意义(P=0.048);不同TRACK评分组哮喘患儿的TPTEF/TE(%)(F=3.171,P=0.044)和VPEF/VE(%)(F=3.919,P=0.022)差异有统计学意义,进一步多重比较发现其差异主要来自于≥80分组与60~80分组,其中VPEF/VE(%)(P=0.017)的组间差异较TPTEF/TE(%)(P=0.030)更为明显;比较不同C-ACT评分组哮喘患儿的FEV1%差异无统计学意义(F=1.756,P=0.182)。结论:TRACK评分能更好反映儿童肺功能的差异,可作为5岁以下儿童哮喘管理的一个有效评估工具。
文摘目的探讨改良中文版儿童呼吸和哮喘控制测试(Test for Respiratory and Asthma Control in Kids Chinese Version,TRACK-C)在0~3岁哮喘婴幼儿不同患病时期的应用价值。方法选取2017年8月—2023年1月空军军医大学唐都医院小儿哮喘门诊中已建立标准化电子病历的203名0~3岁哮喘患儿作为哮喘组,同期100名健康儿童作为对照组。比较各组的TRACK-C评分、潮气肺功能、呼出气一氧化氮(Fractional Exhaled Nitric Oxide,FeNO)水平并进行相关性分析。结果哮喘组的FeNO、呼吸频率(Respiratory Rate,RR)和血液IgE水平高于对照组,达峰值时间比(Time to Peak Expirtory Flow/Time of Expiratory,TPTEF/TE)、达峰容积比(Volume to Peak Expiratory Flow/Volume of Expiratory,VPEF/VE)、公斤潮气量(Tidal Volume/kg,VT/KG)、TRACK-C评分水平低于对照组,差异有统计学意义(P均<0.05)。哮喘组急性期FeNO水平、RR水平高于缓解期,且TPTEF/TE、VPEF/VE、VT/KG、TRACK-C评分水平低于缓解期,差异有统计学意义(P均<0.05)。采用Pearson分析哮喘不同患病时期与各项观察指标的相关性,结果显示哮喘不同患病时期与TPTEF/TE、VPEF/VE、TRACK-C评分呈负相关(r=-0.468、-0.452、-0.289,P均<0.05)。结论TRACK-C评分可充分应用于0~3岁哮喘幼儿的病情评估,与潮气肺功能结合可以更好地对低龄患儿进行哮喘管理。
文摘目的探讨奥马珠单抗治疗儿童过敏性哮喘的临床疗效。方法选取2021年8月至2022年3月首都医科大学附属北京儿童医院过敏反应科确诊为过敏性哮喘并应用奥马珠单抗治疗的患儿。根据治疗有效性全球评估(global evaluation of treatment effectiveness,GETE)分析患儿治疗16周时的临床疗效,并观察治疗4周和16周时儿童哮喘控制测试(childhood asthma control test/asthma control test,c-ACT/ACT)得分,哮喘和鼻炎视觉模拟评分(visual analogue scale,VAS),哮喘生活质量调查问卷(mini Asthma Quality of Life Questionnaire,mini-AQLQ)得分,每日激素剂量,血清总IgE、肺功能和呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)情况。结果共纳入35例患儿,其中77.1%的患儿在治疗16周时对奥马珠单抗有“极好”或“好”的应答。与治疗前相比,治疗4周和16周时患儿的c-ACT/ACT得分均升高[25.0(20.3,26.8)分,24.5(21.5,27.0)分比23.0(18.0,23.0)分;23.5(21.3,24.8)分,24.5(24.0,25.0)分比22.0(18.0,24.8)分],哮喘VAS[1.0(0.0,2.8)分,1.0(0.0,1.0)分比2.3(0.6,6.3)分]和鼻炎VAS[1.0(0.0,4.8)分,1.4(0.1,3.0)分比4.7(2.1,5.9)分]均下降,哮喘mini-AQLQ评分均升高[98.5(93.0,103.0)分,103.0(98.5,103.8)分比91.0(83.3,96.5)分],差异均有统计学意义(P<0.05)。与治疗前相比,治疗16周时患儿的每日激素剂量下降[100.0(71.0,150.0)μg比160.0(125.0,200.0)μg]、血清总IgE明显升高[1593.0(1131.0,2367.0)kU/L比684.0(331.0,1489.0)kU/L],差异均有统计学意义(P=0.000)。与治疗前相比,治疗16周时患儿肺功能指标无明显改善,差异均无统计学意义(P>0.05),但FeNO显著降低,差异有统计学意义(P<0.05)。结论在过敏性哮喘儿童中应用奥马珠单抗,可以减少患儿临床症状和糖皮质激素的剂量,改善患儿生活质量。
文摘目的调查门诊哮喘患者控制水平的现状以及初步哮喘管理对于提高哮喘控制水平的可能获益。方法选择2011年7月到2011年9月间在我科门诊就诊的哮喘患者,评估其控制水平和其他临床特征。结果共有198例患者完成评测,管理不依从组117例,依从组81例;整体哮喘控制测试(asthma control test,ACT)评分(18.08±4.67)分,6.57%的患者ACT得分25分;依从管理组患者哮喘控制水平、治疗依从性、急性加重的频率和患者比例等均显著优于不依从管理的患者,而两组间患者对卫生经济负担的负担能力相当。结论门诊哮喘患者控制率低,初步实施哮喘管理即可显著提高患者哮喘控制水平。
