소아천식에서 천식 조절 상태 평가 도구의 유용성
Utility of tools for the assessment of asthma control in childhood asthma
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: The goal of asthma control is to maintain well-controlled state. In this study, we investigated whether childhood asthma control test (C-ACT) may reflect lung function and whether fractional exhaled nitric oxide (FeNO) can be used to improve the accuracy of C-ACT in reflecting the asthma control level. Methods: We reviewed the medical records of 155 patients with asthma underwent lung function tests and C-ACT upon visiting our outpatient clinic. We compared lung function test results according to the C-ACT score stratified by atopy and also examined FeNO according to C-ACT and the Global Initiative for Asthma (GINA) guidelines. The diagnostic accuracy of well-controlled asthma by C-ACT, FeNO, and C-ACT+FeNO was examined. We also calculated the cutoff value of FeNO and C-ACT for well-controlled asthma. Results: Peak expiratory flow (PEF) showed a significant correlation with the C-ACT score. Stratified by atopy, PEF, and forced expiration in one second (FEV1) showed significant correlations with the C-ACT score in the atopic asthma group. There was no difference in FeNO between subjects with C-ACT≥20 and <20, but FeNO was significantly higher in the uncontrolled asthma according to the GINA guidelines. The diagnostic accuracy of well-controlled asthma was higher when FeNO was combined with the C-ACT score than C-ACT or FeNO. Our study showed that the cutoff values of C-ACT and FeNO 19 and 18.3 ppb (parts per billion), respectively, for well-controlled asthma. Conclusion: C-ACT showed a significant correlation with PEF, and atopic asthma group showed significant correlations with PEF and FEV1. A combination of C-ACT with FeNO might reflect asthma control status more accurately.
Abstract
Purpose: The goal of asthma control is to maintain well-controlled state. In this study, we investigated whether childhood asthma control test (C-ACT) may reflect lung function and whether fractional exhaled nitric oxide (FeNO) can be used to improve the accuracy of C-ACT in reflecting the asthma control level. Methods: We reviewed the medical records of 155 patients with asthma underwent lung function tests and C-ACT upon visiting our outpatient clinic. We compared lung function test results according to the C-ACT score stratified by atopy and also examined FeNO according to C-ACT and the Global Initiative for Asthma (GINA) guidelines. The diagnostic accuracy of well-controlled asthma by C-ACT, FeNO, and C-ACT+FeNO was examined. We also calculated the cutoff value of FeNO and C-ACT for well-controlled asthma. Results: Peak expiratory flow (PEF) showed a significant correlation with the C-ACT score. Stratified by atopy, PEF, and forced expiration in one second (FEV1) showed significant correlations with the C-ACT score in the atopic asthma group. There was no difference in FeNO between subjects with C-ACT≥20 and <20, but FeNO was significantly higher in the uncontrolled asthma according to the GINA guidelines. The diagnostic accuracy of well-controlled asthma was higher when FeNO was combined with the C-ACT score than C-ACT or FeNO. Our study showed that the cutoff values of C-ACT and FeNO 19 and 18.3 ppb (parts per billion), respectively, for well-controlled asthma. Conclusion: C-ACT showed a significant correlation with PEF, and atopic asthma group showed significant correlations with PEF and FEV1. A combination of C-ACT with FeNO might reflect asthma control status more accurately.
참고문헌 (25)
- "GINA report, global strategy for asthma management and prevention" (2014)[URL]
- (2007)[URL]
- Payne DN, "Relationship between exhaled nitric oxide and mucosal eosinophilic inflammation in children with difficult asthma, after treatment with oral prednisolone", Am J Respir Crit Care Med, 164(8 Pt 1), pp.1376~1381 (2001)
- Kharitonov SA, "Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children", Eur Respir J, 21, pp.433~438 (2003)
- Green RH, "Asthma exacerbations and sputum eosinophil counts : a randomised controlled trial", Lancet, 360, pp.1715~1721 (2002)
- Nathan RA, "Development of the asthma control test : a survey for assessing asthma control", J Allergy Clin Immunol, 113, pp.59~65 (2004)
- Juniper EF, "Development and validation of a questionnaire to measure asthma control", Eur Respir J, 14, pp.902~907 (1999)
- Murphy KR, "Test for respiratory and asthma control in kids (TRACK): a caregiver-completed questionnaire for preschool-aged children", J Allergy Clin Immunol, 123, pp.833~839.e9 (2009)
- LeBlanc A, "Quantification of asthma control : validation of the Asthma Control Scoring System", Allergy, 62, pp.120~125 (2007)
- Schatz M, "Asthma control test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists", J Allergy Clin Immunol, 117, pp.549~556 (2006)
- Liu AH, "Development and cross-sectional validation of the Childhood Asthma Control Test", J Allergy Clin Immunol, 119, pp.817~825 (2007)
- Yu HR, "Comparison of the Global Initiative for Asthma guideline-based Asthma Control Measure and the Childhood Asthma Control Test in evaluating asthma control in children", Pediatr Neonatol, 51, pp.273~278 (2010)
- Papakosta D, "Asthma control test is correlated to FEV1 and nitric oxide in Greek asthmatic patients : influence of treatment", J Asthma, 48, pp.901~906 (2011)
- 김정옥, "소아 아토피 천식 환자에서 호기 NO 농도와 천식 조절 점수 및 폐기능검사 결과 사이의 연관성", Allergy Asthma & Respiratory Diseases, 21(1), pp.24~31 (2011), 대한 소아알레르기 호흡기학회
- Miller MR, "Standardisation of spirometry", Eur Respir J, 26, pp.319~338 (2005)
- 송대진, "건강한 학동기 아동의 폐기능검사 추정정상치", Allergy Asthma & Respiratory Diseases, 12(2), pp.105~113 (2002), 대한 소아알레르기 호흡기학회
- Crapo RO, "Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999", Am J Respir Crit Care Med, 161, pp.309~329 (2000)
- American Thoracic Society, "ATS", ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005, 2005, pp.171, 912~930
- Pijnenburg MW, "Exhaled nitric oxide in childhood asthma : a review", Clin Exp Allergy, 38, pp.246~259 (2008)
- Khalili B, "Discrepancy between clinical asthma control assessment tools and fractional exhaled nitric oxide", Ann Allergy Asthma Immunol, 101, pp.124~129 (2008)
- Shirai T, "Relationship of the asthma control test with pulmonary function and exhaled nitric oxide", Ann Allergy Asthma Immunol, 101, pp.608~613 (2008)
- Senna G, "Correlation among FEV, nitric oxide and asthma control test in newly diagnosed asthma", Allergy, 62, pp.207~208 (2007)
- Yavuz ST, "Identifying uncontrolled asthma in children with the childhood asthma control test or exhaled nitric oxide measurement", Ann Allergy Asthma Immunol, 109, pp.36~40 (2012)
- Ito Y, "Association between the results of the childhood asthma control test and objective parameters in asthmatic children", J Asthma, 48, pp.1076~1080 (2011)
- Melosini L, "Asthma control test (ACT): comparison with clinical, functional, and biological markers of asthma control", J Asthma, 49, pp.317~323 (2012)