The Relationship of Spirographic Parameters and Bronchial Responsiveness with Asthma Control Level in Children (According to ACQ-5 and АСТ-С Data)

The aim of the investigation was to assess the relationship of ACQ-5 and ACT-C indices and spirographic parameters in children with bronchial asthma (BA), reveal confidential intervals of these parameters typical for different levels of BA control. The BA levels were determined according to these questionnaires.

Materials and Methods. We examined 130 patients aged from 5 to 11 years with primarily atopic BA and different control level of the disease. In addition to routine examination, all children underwent the tests to determine BA control level using Asthma control questionnaire — 5 (ACQ-5) and Childhood Asthma control test (АСТ-С). Spirographic examination was performed using Master-Screen Pneumo (Jaeger, Germany). Bronchial hyperresponsiveness was studied in tests with physical load (veloergometer Kettler AX1). The test with bronchial spasmolytic was used in children with exacerbation of the disease.

Results. According to ACQ-5, 90 children had complete control of the disease symptoms (ACQ-5<0.75 scores), 17 children — partial control (0.751.5 scores). According to АСТ-С, in the same children, 95 children had controlled BA course (АСТ-С≥20 scores), 35 patients — lack of control (АСТ-С≤19). The correlation between ACQ-5 and АСТ-С was –0.62, when p<0.00001.

The control level assessment according to ACQ-5 showed the average values of forced expiratory volume in 1 s (FEV1) in patients with complete BA control to be 98.99±10.56%, with partial control — 91.53±10.94%, with no control — 72.56±7.17%, p<0.00001. The correlation between ACQ-5 and FEV1 was –0.7, when p<0.00001.
The control level estimated by ACT-C showed the average values of FEV1 in patients with the achieved BA control to be 95.78±12.38%, with the lack of control — 85.99±17.08%; p=0.0007. The correlation between ACT-C and FEV1 was 0.37, when p<0.00001.
We assessed the intensity of bronchial responsiveness estimated by the tests with physical load or with bronchial spasmolytics (taking into consideration initial clinical status and spirogram findings) in 40 patients. As BA control level decreased, there was found the bronchial responsiveness rising. The correlation between ACQ-5 and the intensity of bronchial responsiveness was –0.55, when p=0.0001, that exceeded the correlation relationship between ACT-C and this parameter (R=0.33; p=0.03).

Conclusion. When diagnosing BA control level, one should take into consideration that spirographic parameters, as well as the intensity of bronchial responsiveness in the conditions of modern pharmacotherapy, demonstrate closer correlation with ACQ-5 indices compared to АСТ-С.

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Eliseeva Т.I., Knyazeva Е.V., Geppe N.A., Balabolkin I.I. The Relationship of Spirographic Parameters and Bronchial Responsiveness with Asthma Control Level in Children (According to ACQ-5 and АСТ-С Data). Sovremennye tehnologii v medicine 2013; 5(2): 47