CAJ | 학술논문

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≤1 9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(FEV1)、FEV1占预计值百分比(FEV1％pred)等肺功能指标呈止相关,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.
목적 평개효천공제측시(ACT)전삼항(ACT-3)여ACT재판단지기관효천(간칭효천)공제수평시적일치성,이획득경위간편적효천공제평고방법.방법 연구대상위남방의원문진진단위효천적환자102례,환자정재접수혹미접수규범화효천치료.소유환자완성ACT평분급폐공능검사.ACT평분≤1 9분정의위효천미공제,ACT평분≥20분정의위량호공제.분석ACT여ACT-3량자적상관성급여폐공능각지표적상관성,분석ACT여ACT-3판단효천미공제적개치,병통과kappa계수평개ACT 3여ACT판단적문합도.결과 입선적환자ACT-3여ACT적상관계수위0.919(P =0,000).ACT-3、ACT분별우폐공능지표제1초용력호기용적(FEV1)、FEV1점예계치백분비(FEV1％pred)등폐공능지표정지상관,상관계수차이균유통계학의의.ACT-3판단효천미공제적ROC곡선하면적(AUC)위0.974(P=0.000).당ACT-3≤11분시,위최가절단점,판단효천미공제적민감성위94.52％,특이성위93.10％.ACT-3≤11분화ACT≤19분판단효천미공제적일치성검험:kappa계수=0.858(P=0.000).결론 ACT-3능용우평개효천환자공제수평,이ACT-3≤11식별효천미공제시여ACT≤19유겁고적일치성.당ACT무법완정획취시가이고필사용ACT-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.