呼气峰流量日变异率及哮喘控制测试评分在哮喘病情监测中的作用

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摘要目的：探讨呼气峰流量（PEF）日变异率与哮喘控制测试（ACT）评分的关系，分析两者在哮喘病情监测中的应用价值。方法：选取2013年7月-2013年12月我院门诊就诊哮喘患者64例为研究对象。每天4个时间点（6:00，12:00，18:00，24:00）记录患者PEF值，计算PEF日变异率。每位患者就诊时常规记录ACT及一秒钟呼气流量占预计值百分比（FEV1%）。结果：PEF日变异率与FEV1%及ACT评分均无相关关系，但ACT评分与FEV1%有较好的相关关系（r=0.658，P＜0.05），其直线回归方程为：Y=49.79+1.48X。PEF日变异率用于评估哮喘病情（以PEF日变异率=20%为截点值）的曲线下面积为0.976，敏感性为100%，特异性为85.4%。ACT评分用于评估哮喘病情（以ACT评分=20分为截点值）的曲线下面积为0.771，敏感性为65.2%，特异性为64.6%。两者联合用于评估哮喘病情的曲线下面积为0.767，敏感性为45%，特异性为100%。未控制哮喘（ACT＜20或PEF日变异率≥20%）患者ACT评分与PEF日变异率无相关关系，但对于哮喘控制较好（ACT≥20且PEF日变异率＜20%）的患者，ACT评分与PEF日变异率有负相关关系（r=-0.602，P＜0.01）。结论：哮喘患者ACT评分可以用于推测患者FEV1%。PEF日变异率及ACT单独应用能监测哮喘病情，但联合应用可以提高评估病情的准确性。对于哮喘控制较好（ACT≥20及PEF日变异率＜20%）的患者，可以由ACT评分来推测PEF日变异率。

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	金玲玲
	林慧
	戴元荣

关键词 ：哮喘, 呼气峰流量日变异率, 哮喘控制测试

Abstract：Objective: To explore the value of application of diurnal peak expiratory flow variability and asthma control test (ACT) in monitoring patients with bronchial asthma. Methods: Sixty-four asthmatic patients were collected from section for outpatients of the Second Affiliated Hospital of Wenzhou Medical University dating from July 2013 to December 2013. Their peak expiratory flow readings were determined with four times a day (6:00, 12:00, 18:00, 24:00). The diurnal peak expiratory flow variability and the average individually were calculated, at the same time the ACT and the first breath rate of expected percentage (FEV1%) were recorded. Results: Diurnal peak expiratory flow variability showed no relationship with FEV1% and ACT scores, but ACT had positive correlation with FEV1% (r=0.658, P<0.05), the linear regression relationship was Y=49.79+1.48X. The area under the curve in receiver operator characteristic curve of diurnal peak expiratory flow variaility was 0.976 (cutoff point 0.2, sensitivity 100% and specificity 85.4%). The area under the curve in receiver operator characteristic curve of ACT was 0.771 (cutoff point 20, sensitivity 65.2% and specificity 64.6%). The area under the curve in receiver operator characteristic curve of diurnal peak expiratory flow variability together with ACT was 0.767 (sensitivity 45%, specificity 100%). ACT of patients with poorly controlled showed no correlation with diurnal peak expiratory flow variability, but in patients with well controlled, the ACT scores and diurnal peak expiratory flow variability had negative correlation (r=-0.602, P<0.01). Conclusion: ACT score can be used to speculate asthma patients’ FEV1% lung function index. Diurnal peak expiratory flow variability and ACT can be used in monitoring asthmaseparatly,so can they used together. In patients with asthma better controlled, doctoers can separate peak expiratory flowvariation rate by ACT score.

Key words： asthma diurnal peak expiratory flow variability asthma control test

收稿日期: 2014-09-23

通讯作者: 戴元荣，主任医师，硕士生导师，Email：daiyr@126.com。

作者简介: 金玲玲（1988-），女，浙江温州人，硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I8/579

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