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目的：观察在哮喘缓解期阶梯治疗中，哮喘控制测试(asthma control test, ACT)与最大呼气峰流速(PEF)作用的相关性，帮助支气管哮喘患者更加准确、简便的进行自我监测，提高患者的依从性。方法：选择我院哮喘专病门诊就诊的78 例哮喘患者，吸入糖皮质激素(ICS)进行缓解期的阶梯治疗。要求每日早、晚监测PEF，并记录到哮喘日记上。每月哮喘专病门诊复诊一次，了解PEF 值、PEF占个人预计值的百分比(PEFpred %)，PEFpred %>个人预计值80 %为哮喘控制，PEFpred %<个人预计值80 %为哮喘未控制，同时进行ACT 问卷，计算得分，<20 分为哮喘未控制；20~ 25 分为哮喘控制。结果：ACT 评分20～25 分组与ACT 评分<20 分组PEFpred%比较，差异有统计学意义(P<0.01)。PEFpred%>个人预计值80 %组与PEFpred%< 个人预计值80 %组ACT 评分比较，差异有统计学意义(P<0.01)。ACT 评分与PEFpred%具有线性相关关系，P<0.001。结论：在哮喘缓解期阶梯治疗中，ATC评分与 PEF具有良好的相关性, 对于没有条件或不能监测PEF的哮喘患者可以用ACT 评分作为评估哮喘控制的指标，指导阶梯治疗。

英文摘要:

Objective:To observe the correlation of asthma control test (ACT) and peak expiratory flow (PEF) in the stepped therapy for the remission period of asthma patients.Methods:78 out-patient with asthma in our hospital were selected and carried out the stepped therapy in remission with inhaled corticosteroids (ICS), and the patients were asked to monitor PEF daily in the morning and evening by filling the chart. An outpatient visit was done once a month for calculating PEF value and percentage of the predicted value in PEF of each individual( PEFpred %) . The asthma was thought to be under control by value of PEFpred%> 80 %, whereas, PEF pred % <80%was failure. Also, ACT questionnaire was conducted for the scores, and the scores< 20 on the list indicated failure of control while those of 20~ 25 were thought to be well controlled.Results:Comparison of PEF pred % between ACT score < 20 and the one 20~ 25 suggested statistical difference (P < 0.01). By ACT scores, PEF pred% < 80%were also different fromPEF pred%>80% (P < 0 .01). ACT scores were linearly correlated with PEF pred %.Conclusion:In the stepped therapy for the remission period of asthma, there is a good correlation between ACT scores and PEFpred %. vn some asthma patients incapable of being monitored PEF, ACT scores can be valuable marker for the evaluation of asthma control to direct the stepped care of asthma.

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