文章摘要
蔡纹纹,包玉玲.改良中文版儿童呼吸和哮喘控制测试(TRACK⁃C)的临床应用价值验证[J].南京医科大学学报,2020,(11):1639~1644
改良中文版儿童呼吸和哮喘控制测试(TRACK⁃C)的临床应用价值验证
Modified test for respiratory and asthma control in kids⁃Chinese version(TRACK⁃C):verification of the clinical application
投稿时间:2020-05-23  
DOI:10.7655/NYDXBNS20201112
中文关键词: 哮喘  儿童  TARCK⁃C  信度  效度
英文关键词: asthma  children  TRACK⁃C  reliabilitaion  validation
基金项目:江苏省青年医学人才项目(QNRC2016087)
作者单位
蔡纹纹 南京医科大学附属儿童医院呼吸科江苏 南京 210008 
包玉玲 南京医科大学附属儿童医院呼吸科江苏 南京 210008 
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中文摘要:
      目的:探讨改良中文版儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids?Chinese version,TRACK?C)在中国5岁以下哮喘儿童临床应用中的信度和效度。方法:利用回顾性调查问卷收集5岁以下哮喘儿童的相关基础信息;结合TARCK?C评估哮喘儿童的哮喘相关症状及用药情况;将TRACK?C的评估结果与全球哮喘防治创议(global initiative for asthma,GINA)指南的哮喘控制评估结果进行比较,检验TRACK?C评估与GINA指南定性评估间的信度和效度。结果:共纳入136例患儿作为研究对象,问卷的中位数为95分,克朗巴赫α系数为0.704分,一致性较好。上个月看过急诊的患儿评分显著低于不需要紧急就诊的患儿,差异有统计学意义(P < 0.001);在最近1个月内是否使用过糖皮质激素的儿童中,差异无统计学意义(P > 0.05);近1个月有喘息发作患儿的评分显著低于无喘息儿童(P < 0.001);当儿童按照GINA标准评判时,部分控制组患儿的得分显著低于完全控制组,差异有统计学意义(P < 0.001)。当儿童按照临床医生的标准区分时,未控制组、部分控制组以及完全控制组的评分也有显著差异(P < 0.001)。不同呼吸道症状控制的评分界值比较,以90分为界值的ROC曲线下面积最高,为0.943。结论:TARCK?C有较好的临床信度(内部一致性)和效度(与GINA指南控制水平比较),可以作为区分不同呼吸道症状及控制水平儿童的有用工具,值得在中国5岁以下儿童哮喘管理中推广使用。
英文摘要:
      Objective:This study aims to explore the reliability and validity of the modified test for respiratory and asthma control in kids?Chinese version(TRACK?C) in the clinical application of children under 5 years old with asthma in China. Methods:A retrospective questionnaire was used to collect basic information related to asthma children under 5 years old. TARCK?C was used to evaluate symptoms and medication in children with asthma. The results of TRACK?C were compared with GINA guidelines to test the reliability and validity. Results:A total of 136 children were enrolled in the study. The median score of the TRACK?C questionnaire was 95 and Cronbach’s α was 0.704. The scores of children who had visited the emergency department last month were significantly lower than those of children who hadn’t,and the differences were statistically significant(P < 0.001). There was no significant difference among the children who had or hadn’t used glucocorticoids in the last month(P > 0.05),but the score of children with wheezing was significantly lower than that of non?wheezing children(P < 0.001). When the children were judged according to the GINA standard,the scores of children in the partially controlled group were significantly lower than those of children in the well controlled group,and the differences were statistically significant(P < 0.001). When children were classified according to the criteria of clinicians,there were also significant differences among the uncontrolled group,the partially controlled group and the well control group(P < 0.001). The cut?off of 90 points had the highest area under the ROC curve(0.943). Conclusion:It was demonstrated that the TRACK?C has satisfactory clinical reliability(internal consistency)and validity(compared with GINA). It can be used as a useful tool to distinguish children with different respiratory symptoms and different control levels,and suggested in asthma management of children under 5 years old in China.
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