Classifying asthma severity in children - Mismatch between symptoms, medication use, and lung function
Classifying asthma severity in children - Mismatch between symptoms, medication use, and lung function
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DOI：
10.1164/rccm.200308-1178oc
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发表时间：
2004-08-15
影响因子：
24.7
通讯作者：
Sorkness, CA
中科院分区：
文献类型：
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作者：
Bacharier, LB;Strunk, RC;Sorkness, CA
目前的哮喘护理指南根据哮喘症状的频率、药物使用和肺功能指标对哮喘严重程度进行分类。本研究的目的是确定肺功能指标是否与国家哮喘教育和预防计划/专家小组报告2指南定义的哮喘严重程度水平一致。在两个门诊专科诊所就诊的5-18岁哮喘儿童的父母分别完成了关于前1周和4周哮喘药物使用和症状频率的问卷。所有儿童均进行肺功能测定。当哮喘严重程度基于哮喘症状频率或药物使用的较高严重程度时，6.9%的参与者的哮喘为轻度间歇性，27.9%为轻度持续性，22.4%为中度持续性，42.9%为重度持续性。FEV1%预测值在哮喘严重程度之间无差异。FEV 1/FVC随哮喘严重程度增加而降低（p < 0.0001），33%的受试者FEV 1/FVC异常，且随着哮喘严重程度增加，FEV 1/FVC异常的受试者比例更高（p = 0.0001）。在儿童中，按症状频率和药物使用分类的哮喘严重程度与国家哮喘教育和预防计划指南定义的FEV 1类别无关。FEV 1通常正常，即使在严重的持续性儿童哮喘中也是如此，而FEV 1/FVC随着哮喘严重程度的增加而下降。
Current guidelines for asthma care categorize asthma severity based on the frequency of asthma symptoms, medication use, and lung function measures. The objective of this study was to determine whether lung function measures are consistent with levels of asthma severity as defined by the National Asthma Education and Prevention Program/Expert Panel Report 2 Guidelines. Parents of children aged 5-18 years with asthma seen in two outpatient subspecialty clinics completed questionnaires regarding asthma medication use and symptom frequency over the preceding 1 and 4 weeks, respectively. All children performed spirometry. When asthma severity was based on the higher severity of asthma symptom frequency or medication use, asthma was mild intermittent in 6.9% of participants, mild persistent in 27.9%, moderate persistent in 22.4%, and severe persistent in 42.9%. FEV1 % predicted did not differ by level of asthma severity. FEV1/FVC decreased as asthma severity increased (p < 0.0001) and was abnormal in 33% of the participants, and a greater percentage of participants had an abnormal FEV1/FVC as asthma severity increased (p = 0.0001). In children, asthma severity classified by symptom frequency and medication usage does not correlate with FEV1 categories defined by National Asthma Education and Prevention Program Guidelines. FEV1 is generally normal, even in severe persistent childhood asthma, whereas FEV1/FVC declines as asthma severity increases.