中国改良版呼吸和哮喘控制测试在5岁以下儿童哮喘中的应用价值  

VALUE OF MODIFIED CHINESE VERSION OF TEST FOR RESPIRATORY AND ASTHMA CONTROL IN KIDS IN ASSESSING CONTROL OF ASTHMA IN UNDER-5-YEAR-OLD CHILDREN

作　　者：吕升扬 林荣军[1] 路玲[1] 管仁政[1] 王仙金 LU Shengyang;LIN Rongjun;LU Ling;GUAN Renzheng;WANG Xianjin(Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院儿科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2020年第4期473-476,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2017WS122)。

摘　　要：目的探讨中国改良版呼吸和哮喘控制测试(TRACK)对5岁以下哮喘儿童哮喘控制的评价作用。方法选择100例临床确诊为哮喘的5岁以下儿童,给予吸入糖皮质激素(ICS)为主的药物雾化治疗1周。连续复诊3个月,每月均分别采用《儿童支气管哮喘诊断与防治指南(2016年版)》中的儿童哮喘症状控制水平分级(简称儿童哮喘症状控制水平分级)及中国改良版TRACK对100例哮喘儿童进行哮喘控制水平评估。比较两种方法评估儿童哮喘控制情况一致性。结果随访3个月后以儿童哮喘症状控制水平分级为分组标准,将100例哮喘病儿分为控制良好组64例、部分控制组29例、未控制组7例,3组病儿TRACK得分中位数分别为95、80、50分,3组TRACK得分比较差异有统计学意义(H=56.498,P<0.001),3组间两两比较差异均有统计学意义(U=3.454~6.647,P<0.001)。治疗后随访1、2、3个月,两种方法分级一致性检验Kappa值分别0.656、0.706和0.573,有较高的吻合度。结论中国改良版TRACK与儿童哮喘症状控制水平分级结果有较高的一致性,可应用于5岁以下哮喘儿童哮喘控制水平的评估。Objective To explore the value of modified Chinese version of Test for Respiratory and Asthma Control in Kids(TRACK)in assessing control of asthma in under-5-year-old children.Methods A total of 100 under-5-year-old children with clinically confirmed asthma were enrolled and treated with inhaled corticosteroids-based aerosol treatment for 1 week.The children were followed up at the subsequent visits for three consecutive months,and were evaluated,during each of the three months,for asthma control level using the childhood asthma control level grading in the Guidelines for the Diagnosis and Management of Bronchial Asthma in Children(2016 edition)(hereinafter referred to as childhood asthma control level grading)and the modified Chinese version of TRACK.The two methods were compared to evaluate their agreement in assessing childhood asthma control.Results After 3 months of follow-up,the 100 children with asthma were divided into well-controlled group(64 cases),partially-controlled group(29 cases),and uncontrolled group(7 cases),with childhood asthma control level grading taken as the criteria for grouping.The three groups of children had median TRACK scores of 95,80,and 50,respectively,with significant differences observed between the three groups(H=56.498,P<0.001);meanwhile,pairwise comparisons between the three groups also showed significant differences(U=3.454-6.647,P<0.001).At follow-ups 1,2,and 3 months after treatment,the Kappa values in the agreement tests for the two methods were 0.656,0.706,and 0.573,respectively,indicating a relatively high degree of agreement.Conclusion The modified Chinese version of TRACK has a relatively high degree of agreement with the childhood asthma control level grading,so it is applicable in assessing asthma control level in under-5-year-old children with asthma.

关 键 词：哮喘 儿童 调查和问卷 可行性研究 

分 类 号：R725.6[医药卫生—儿科]