支气管哮喘患者症状感知控制水平的差异性及其影响因素分析  

The Differences in Self-perception Level of Asthma Control and Related Influencing Factors in Asthmatic Patients

作　　者：尚玉姣 李世敏[1] 孔英君[1] 

机构地区：[1]哈尔滨医科大学附属第一医院呼吸内科,黑龙江哈尔滨150001

出　　处：《中国呼吸与危重监护杂志》2015年第6期553-559,共7页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：哈尔滨市科技创新人才研究专项资金项目(编号:2012RFXXS011)

摘　　要：目的分析支气管哮喘患者自我感知控制水平与症状控制水平的差异性,探讨影响支气管哮喘患者自我感知控制水平的相关因素。方法选取2013年3月至2015年2月于哈尔滨医科大学第一附属医院就诊并确诊的322例支气管哮喘患者,调查其人口学特征,完成哮喘控制问卷(ACT),并收集填写问卷当日的血常规、肺功能检查结果。第1、3、6、12个月进行随访,并再次填写ACT问卷,行血常规及肺功能检查。在随访期间定期组织哮喘相关健康教育。结果符合入组条件并完成上述指标采集的共226例。支气管哮喘患者自我感知控制水平与实际症状控制水平间存在显著差异性(P<0.05)。年龄≥65岁的哮喘患者自我感知控制水平准确性较低(P=0.000)。高中及以上文化程度患者自我感知控制水平准确性较高(P=0.005)。合并过敏性鼻炎患者较未合并鼻炎患者的感知控制水平准确性低(P=0.001)。合并过敏性鼻炎的患者规律治疗鼻炎的时间越长,其自我感知准确率越高(P=0.000)。接受哮喘教育后的哮喘患者自我感知控制水平准确率较前明显提高(P=0.000)。哮喘患者外周血嗜酸粒细胞绝对值与哮喘的急性发作有显著相关性(P=0.003),对于评估未来哮喘急性发作的风险有一定作用,但与患者自我感知控制水平的准确性无明显相关性(P=0.469)。结论支气管哮喘患者自我感知控制水平与症状控制水平之间具有显著差异性。高龄、低文化水平、合并过敏性鼻炎或者未接受哮喘教育的哮喘患者自我感知控制水平准确性较低。哮喘患者外周血嗜酸粒细胞水平可评估未来哮喘急性发作的风险,与患者自我感知控制水平的准确性无明显相关性。Objective To investigate the differences in self-perception level of asthma control and the factors affecting the ability of self-perception in patients with bronchial asthma. Methods A total of 322 patients who were diagnosed with bronchial asthma at the First Affiliated Hospital of Harbin Medical University from March 2013 to February 2015 were recruited in the study. The clinical data were collected,including the demographic characteristics of the patients,the Asthma Control Test（ ACT） and results of routine blood test and pulmonary function test on the same day that they were required to fill out the ACT.Then they were followed up at the 1^st,3^rd,6^th,12^th months,and required to fill out the ACT again,and underwent the blood routine test and lung function test. In addition,health education about asthma was offered regularly during these visits. Results A total of 226 patients met the inclusion criteria of the study.The patients with asthma had significant differences between self-perception control level and real symptoms control level（ P〈0. 05）. The patients who were 65 years old or older perceived their symptoms of bronchial asthma rather poorly（ P = 0. 000）. The patients who received senior high school or higher education had a higher ability of self-perceived asthma control（ P = 0. 005）. The patients with allergic rhinitis combined were less likely to correctly perceive their illness compared with those who did not suffered from allergic rhinitis,and the difference was statistically significant（ P = 0. 001）. In addition,for those diagnosed with allergic rhinitis combined with bronchial asthma,regular treatment also made difference-- longer treatment for rhinitis means a higher ability of self-perceived asthma control（ P = 0. 000）. The health education did play a constructive role in helping patients correctly perceive their illness（ P = 0. 000）. There was no correlation between the absolute value of peripheral blood eosinophils and the accuracy of self-perceived asthma cont

关 键 词：哮喘 自我感知控制水平 影响因素 

分 类 号：R562.25[医药卫生—呼吸系统]