哮喘日志和肺通气功能对应监测联合哮喘控制测试(act)在哮喘患者管理中的应用

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1、授予单位代码10089学号或申请号13014HebeiMedicalUniversity硕士学位论文在职硕士学位哮喘日志和肺通气功能对应监测联合哮喘控制测试（ACT）在哮喘患者管理中的应用作者姓名：李有香导师：王平副教授专业：呼吸内科二级学院：河北医科大学第四医院2015年03月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料、原始数据、申

2、报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名导师签章：^河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写,文责自负。目录中文摘要·············································································1英文摘要················································

3、·····························3英文缩写·············································································6研究论文哮喘日志和肺通气功能对应监测联合哮喘控制测试（ACT）在哮喘患者管理中的应用前言·············································································7材料与方法···················································

4、·················8结果·············································································12附图·············································································16附表·············································································23讨论···························

5、··················································29结论·············································································31参考文献·······································································32综述支气管哮喘常用评估指标的综合评价································35致谢··························

6、·························································51个人简历·············································································52中文摘要哮喘日志与肺通气功能对应监测联合哮喘控制测试在哮喘患者管理中的应用摘要支气管哮喘（简称哮喘）是世界范围内患病率和死亡率都很高的慢性[1,2,3]疾病之一，有证据表明在近20年来哮喘的发病率明显上升。GINA[4]提出哮喘治疗的目的是达到并维持哮喘控制。然而，近几年，虽然哮喘的正确诊断率和

7、治疗率有所提高，但针对每一位哮喘患者病情评估的准确性和治疗的有效性可以说很低，哮喘控制的达标率仍然离我们的期望值很[1]远。不论是用指南的控制评估,还是ACT评分、ACQ问卷对哮喘的控制情况进行评估，即使是接受了依据指南分级治疗的哮喘患者，达到完全控制的比例还是微乎其微，目前全球也仅大约5%的哮喘患者达到完全控制[5,6]。相当多哮喘患者日常活动受限、非预约的门诊就诊、急诊就诊率仍然很[7]高，疾病造成的社会负担不断增加，治疗上的进步并没有提高哮喘的控制[8，9，10]达标率也没有降低哮喘的整体死亡率。就哮喘控制达