The control effect and pulmonary function outcome of standardized treatment management for children with bronchial asthma / 国际儿科学杂志

ABSTRACT

Objective To analyze the effects on control rate and the outcome of pulmonary function in children with bronchial asthma (abbreviated asthma) who were received the two years standardized treatment and management,and to explore the sensitive parameters of control effects in children with asthma.Methods Using the retrospective analysis,asthmatic children were selected from January 2014 to January 2015 in Beijing Children's Hospital,allergy and asthma outpatient clinics.All the patients were received asthma control treatment and management according to GINA guidelines (2014 version).They were assessed on asthma control level at one year and two years follow up visits respectively and their pulmonary function were evaluated at the same time.According to response status to therapy and adjustment of step up and down,children were divided into two groups,the stable control group and the difficult to control group.The parameters of sex,age,asthma,combined with rhinitis,allergen sensitization and pulmonary function were compared between the two groups.Results A total of 149 patients were enrolled in this study.The treatment levels were 20.2％,67.1％ and 12.7％ respectively at grade 2,grade 3 and ≥ 4 grade.After Treatment management for one year and two years,the asthma control level were assessed as good control was 81.8％ and 83.2％ respectively (P ＜ 0.05) Each parameter of pulmonary function excepted FEV1/FVC at the one year visit point after treatment and management was significantly higher than that at enrollment (P ＜ 0.05).After two years of treatment and management,PEF％ pred and FEF25 ％ pred was higher than that at first follow up visit (P ＜ 0.05).There were no significantly different on the distribution of sex,age,course of asthma,allergic rhinitis,allergen sensitization and initial control treatment level between the stable control and the difficult to control groups.Asthma control stability status assessment and analysis at the one year follow up visits showed that PEF％ pred was significantly higher in the group of stable control than that in group of difficult to control (97.3 ± 14.3 vs 93.1 ± 15.1,P ＜ 0.05).Asthma control stability starus assessment and analysis at two years follow up visits showed that the positive rate of allergen sensitization was significantly lower in the group of stable control than that in group of difficult to control (P ＜ 0.05),while FEV1/FVC was significantly higher in the group of stable control than that in group of difficult to control (81.0 ± 9.47vs77.4 ± 8.95,P＜0.05).Conclusion School age children asthma control level were improved with longer time regular treatment and management as well as the pulmonary function improvement.Multiple allergenic sensitization and lower PEF％ pred value and FEV1/FVC are suggestive parameters for children with difficult to control asthma.