返回本期列表 作者： Cindy Thamrin1, Regula Nydegger1, Georgette Stern1, Pasca
PMID： 21602542

Correspondence to Professor Urs Frey, University Children's Hospital (UKBB), PO Box, CH-4005 Basel, Switzerland; urs.frey{at}ukbb.ch

1. Contributors CT and UF were responsible for the conception and design of the study and for writing the manuscript. RN and CT performed the majority of the data analysis, aided by GS. PC, SEW, SF, RAW and DRT provided the original data sets used for the analysis and assisted in interpretation of the original data set. PC, SEW, RAW and DRT were involved in advice and feedback for the study and manuscript.

• Received 30 November 2010
• Accepted 7 April 2011
• Published Online First 20 May 2011

Abstract

Background Lung function is a major criterion used to assess asthma control. Fluctuation analyses can account for lung function history over time, and may provide an additional dimension to characterise control. The relationships between mean and fluctuations in lung function with asthma control, exacerbation and quality of life were studied in two independent data sets.

Methods Data from 132 adults with mild to moderate asthma and 159 adults with severe asthma were analysed separately. Fluctuations in twice-daily peak expiratory flow (PEF) over 6 months were measured by α, representing the strength of correlation with past lung function and potentially asthma stability. α and mean percentage predicted PEF (%predPEF) were plotted with and compared between patients grouped by asthma control defined by recent GINA (Global Initiative for Asthma) guidelines, the Asthma Control Questionnaire score, exacerbations and Asthma Quality of Life Questionnaire score. Associations of α and %predPEF with these outcomes were examined using multiple regression analyses.

Results Both α and %predPEF differed with and were significantly associated with GINA-defined asthma control in both the mild to moderate and severe asthma groups. Only α was related to whether or not exacerbations occurred in mild to moderate asthma, while %predPEF was more significantly related than α in severe asthma. In those with severe asthma, only %predPEF was significantly related to Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores.

Conclusion Lung function history quantified by fluctuation analysis provides additional information to mean lung function, and may help characterise the current state of asthma control. It may also potentially aid in phenotyping clinical asthma.