Classifying asthma severity in children - Mismatch between symptoms, medication use, and lung function

被引:320
作者
Bacharier, LB
Strunk, RC
Mauger, D
White, D
Lemanske, RF
Sorkness, CA
机构
[1] Washington Univ, Sch Med, Dept Pediat, Div Allergy & Pulm Med, St Louis, MO 63110 USA
[2] St Louis Childrens Hosp, St Louis, MO 63178 USA
[3] Penn State Univ, Dept Hlth Evaluat Sci, Hershey, PA 17033 USA
[4] Univ Wisconsin, Dept Pediat, Madison, WI 53706 USA
[5] Univ Wisconsin, Dept Med, Madison, WI 53706 USA
[6] Univ Wisconsin, Sch Pharm, Madison, WI 53706 USA
关键词
asthma; children; lung function; severity;
D O I
10.1164/rccm.200308-1178OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:426 / 432
页数:7
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