TRACK与C-ACT评分在儿童哮喘管理中的价值评估  

Value of the scores of test for respiratory and asthma control in kids and childhood asthma control test in childhood asthma management

作　　者：蒋静[1] 李雪梅[1] 石瑾 吴晓彬 曾书旬 周玲 Jiang Jing;Li Xuemei;Shi Jin;Wu Xiaobin;Zeng Shuxun;Zhou Ling(Department of Pediatrics,Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University)

机构地区：[1]重庆市妇幼保健院/重庆医科大学附属妇女儿童医院儿二科,重庆401147

出　　处：《重庆医科大学学报》2024年第7期865-870,共6页Journal of Chongqing Medical University

基　　金：重庆市科技局资助项目(编号:cstc2019jscx-msxmX0193)。

摘　　要：目的:通过研究儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids,TRACK)和儿童哮喘控制测试(childhood asthma control test,C-ACT)与全球哮喘防治创议(global initiative for asthma,GINA)标准哮喘控制水平评估的一致性、与哮喘儿童肺功能指标的相关性,探讨2种评分方法在儿童哮喘管理中的价值。方法:选择2020年8月至2022年3月重庆市妇幼保健院儿科门诊就诊的哮喘患儿135例为研究对象,用TRACK评分表和C-ACT评分表对相应年龄的患儿及其家长进行问卷调查,分析2种评分方法与GINA标准哮喘控制水平评估分级的一致性、与肺功能指标的相关性,并比较不同评分结果组肺功能指标差异。结果:TRACK评分、C-ACT评分与GINA哮喘控制水平分级一致性检验Kappa值分别为0.517和0.531,均显示一致性一般;TRACK评分与TPF%TE和VPF%VE存在显著的正相关,但TRACK评分、C-ACT评分与FEV1%均没有显著性相关;不同TRACK评分组哮喘患儿的FEV1%差异无统计学意义(F=2.054,P=0.134),但多重比较发现≥80分组与<60分组FEV1%的差异有统计学意义(P=0.048);不同TRACK评分组哮喘患儿的TPTEF/TE(%)(F=3.171,P=0.044)和VPEF/VE(%)(F=3.919,P=0.022)差异有统计学意义,进一步多重比较发现其差异主要来自于≥80分组与60~80分组,其中VPEF/VE(%)(P=0.017)的组间差异较TPTEF/TE(%)(P=0.030)更为明显;比较不同C-ACT评分组哮喘患儿的FEV1%差异无统计学意义(F=1.756,P=0.182)。结论:TRACK评分能更好反映儿童肺功能的差异,可作为5岁以下儿童哮喘管理的一个有效评估工具。Objective:To investigate the value of test for respiratory and asthma control in Kids(TRACK)and childhood asthma con⁃trol test(C-ACT)in childhood asthma management by evaluating their consistency with Global Initiative for Asthma(GINA)for stan⁃dard assessment of asthma control and correlation with pulmonary function in children with asthma.Methods:A total of 135 children with asthma who attended the outpatient service of Department of Pediatrics,Chongqing Health Center for Women and Children,from August 2020 to March 2022 were enrolled as subjects.TRACK and C-ACT scales were used to conduct a questionnaire survey among the children with the corresponding age and their parents.The two scoring methods were analyzed in terms of their consistency with GINA asthma control level and correlation with pulmonary function parameters,and pulmonary function parameters were compared between the groups with different scores.Results:The consistency test showed a kappa value of 0.517 between TRACK score GINA asthma control level and 0.513 between C-ACT score and GINA asthma control level,suggesting a moderate degree of coincidence.TRACK score was significantly positively correlated with TPF%TE and VPF%VE,while TRACK score and C-ACT score were not sig⁃nificantly correlated with FEV1%.There was no significant difference in FEV1%between the groups of asthmatic children with differ⁃ent TRACK scores(F=2.054,P=0.134),but multiple comparisons showed that there was a significant difference in FEV1%between the≥80 points group and the<60 points group(P=0.048).There were significant differences between the different TRACK score groups in TPTEF/TE(%)(F=3.171,P=0.044)and VPEF/VE(%)(F=3.919,P=0.022),and further multiple comparisons showed that the differences mainly came from the≥80 points group and the 60~80 points group,among which the difference in VPEF/VE(%)between groups(P=0.017)was more significant than that in TPTEF/TE(%)(P=0.030).There was no significant difference in FEV1%between the groups of children with different C-AC

关 键 词：儿童呼吸和哮喘控制测试 儿童哮喘控制测试 全球哮喘防治创议 哮喘管理 

分 类 号：R725.6[医药卫生—儿科]