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目的对哮喘控制问卷(ACQ)和改良哮喘控制问卷(不计肺功能,简称ACQ6)在儿童哮喘控制评估中应用的可行性进行探讨。方法选取青岛大学医学院附属医院哮喘专家门诊确诊的哮喘患儿102例,进行肺功能测试,包括一秒钟用力呼气量占预计值百分比(FEV1%)和最大呼吸流量占预计值百分比(PEF%),并进行ACQ调查;同时根据2006《哮喘管理和预防的全球策略》的哮喘控制分级标准,对哮喘患儿进行病情界定并分为控制组、部分控制组及未控制组。对3组患儿ACQ和ACQ6得分进行比较;并以FEV1%和PEF%为分组依据,比较ACQ6得分在不同FEV1%、PEF%组间的差异,分析ACQ6得分与FEV1%和PEF%的趋同性和一致性;分别对ACQ得分、ACQ6得分、FEV1%、PEF%与专家哮喘控制评估结果进行相关性分析,以检验其相关密切程度。结果 3组哮喘患儿的ACQ和ACQ6得分比较差异有统计学意义(F=171.52、117.14,Pa<0.01);ACQ6得分在不同FEV1%、PEF%水平间差异均有统计学意义(F=69.53、76.20,Pa<0.01);ACQ6与FEV1%的Spearman相关系数为-0.818,与PEF%的Spearman相关系数为-0.862,ACQ6与PEF%的相关性较FEV1%的相关性高;ACQ得分、ACQ6得分、FEV1%及PEF%与专家评估结果的Spearman相关系数分别为0.931、0.915、-0.878和-0.882,与专家评估结果关系的密切相关程度从高到低依次为ACQ>ACQ6>PEF%>FEV1%。结论 ACQ和ACQ6对不同哮喘控制水平的患儿具有良好的鉴别能力。ACQ完全可应用于儿童哮喘控制水平的评估;在缺乏肺功能设备的基层医院,ACQ6值得推广应用。
Objective To investigate the feasibility of asthma control questionnaire (ACQ) and modified asthma control questionnaire (excluding lung function, referred to as ACQ6) in the evaluation of children with asthma control. Methods A total of 102 asthmatic children diagnosed as asthma specialist at Affiliated Hospital of Medical College of Qingdao University were enrolled in this study. Pulmonary function tests were performed including FEV1% of one second and the percentage of predicted maximum respiratory flow (PEF %), And conducted ACQ investigation. At the same time, children with asthma were defined and divided into control group, partial control group and uncontrolled group according to the Asthma Control Grading Standard 2006 “Global Strategy for Asthma Management and Prevention”. The scores of ACQ and ACQ6 in three groups were compared. The differences of ACQ6 scores in different FEV1% and PEF% groups were compared based on FEV1% and PEF%. The convergence of ACQ6 scores and FEV1% and PEF% And consistency; respectively ACQ score, ACQ6 score, FEV1%, PEF% and expert evaluation of asthma control the correlation analysis to test the relevance of the degree. Results The scores of ACQ and ACQ6 in three groups of children with asthma were significantly different (F = 171.52, 117.14, Pa <0.01). There were significant differences in ACQ6 scores between different FEV1% and PEF% (F = 69.53 , 76.20, Pa <0.01). The Spearman correlation coefficient between ACQ6 and FEV1% was -0.818, the Spearman’s correlation coefficient with PEF% was -0.862, the correlation between ACQ6 and PEF% was higher than that of FEV1% The Spearman correlation coefficients of scores, FEV1%, PEF% and expert evaluation results were 0.931, 0.915, -0.878 and -0.882, respectively. The correlations between the scores of FEV1%, PEF% and experts’ evaluations were ACQ> ACQ6> PEF%> FEV1 %. Conclusion ACQ and ACQ6 have good discriminating ability in children with different levels of asthma control. ACQ can be completely applied to the evaluation of children’s asthma control level; ACQ6 is worth popularizing in primary hospitals lacking of pulmonary function equipment.