Vrijednost testa za kontrolu astme i frakcije izdahnutog dušičnog oksida u dijagnostici i praćenju astme

master's thesis

• Title (english): Value of asthma control and fraction of exhaled nitric oxide in diagnosis and monitoring of asthma
• Author: Liljana Konecki
• Mentor: Gordana Pavliša (mentor)
• Committee member: Sanja Popović-Grle (predsjednik povjerenstva)
• Committee member: Andrea Vukić Dugac (član povjerenstva)
• Committee member: Gordana Pavliša (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2019-09-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Uvod: Astma je heterogena kronična upalna bolest dišnih putova s velikim individualnim
razlikama u manifestacijama i odgovoru na primijenjeno liječenje. U praćenju bolesti
potrebno je redovito procjenjivati stupanj kontrole bolesti što uključuje procjenu kontrole
simptoma, rizika nastupa akutnog pogoršanja, mjerenje plućne funkcije, provjeru
pravilnosti tehnike inhaliranja lijeka, suradljivosti s liječenjem, otkrivanje komorbiditeta koji
doprinose pogoršanju tegoba i kvalitete života. Vrijedan alat za procjenu stupnja kontrole
simptoma je upitnik o kontroli astme (ACT). Frakcija izdahnutoga dušikovog oksida
(FeNO) neinvazivni je marker upale u astmi i može se koristiti za praćenje upale u dišnim
putevima.
Cilj: Cilj ovog istraživanja je odrediti vrijednosti ACT i FeNO testa u procjeni kontrole
astme i učinkovitosti terapije, te ocijeniti povezanost rezultata ACT-a i FeNO-a.
Metode: U istraživanje je uključeno 39 bolesnika (22 žene (56%) i 17 muškaraca
(44%)) prosječne dobi 51 ± 16.7 godina s nekontroliranom astmom prema smjernicama
Globalne inicijative za astmu (GINA), što je zahtijevalo intenziviranje liječenja. Svaki je
ispitanik samostalno ispunio ACT, te je provedeno FeNO testiranje. Na sljedećem
kontrolnom pregledu, koji je uslijedio barem mjesec dana nakon korekcije liječenja,
ispitanici su ponovno samostalno ispunili ACT upitnik i provedeno je FeNO testiranje.
Rezultati: Prosječna vrijednost ACT prije promjene liječenja iznosila je 15.5 ± 5.1, a
kontrolna vrijednost 22.5 ± 3.5 (p< 0.01). Prosječna vrijednost FeNO testa prije promjene
terapije iznosila je 109.2 ± 63.7, a nakon promjene terapije 59.3 ± 47.7 (p< 0.01). Nije
nađeno statistički značajne povezanosti između rezultata ACT-a i FeNO-a prije promjene
terapije (p= 0,116), kao ni nakon korekcije terapije (p= 0,378).
Zaključak: Naše istraživanje je pokazalo da se vrijednosti ACT i FeNO značajno
poboljšavaju nakon intenziviranja liječenja astme. Iako nije nađeno značajne povezanosti
između vrijednosti ACT-a i FeNO-a, radi se o vrijednim parametrima od kojih svaki mjeri
različiti aspekt astme. Njihova kombinacija s drugim kliničkim parametrima omogućuje
nam kompletniju procjenu i monitoriranja stupnja kontrole astme.

Abstract (english)

Introduction: Asthma is a heterogeneous chronic airway inflammatory disease with large
individual differences in manifestations and treatment response. In the disease
monitoring, it is necessary to regularly assess the degree of symptom control, future risk
of adverse outcomes, lung function, inhaler technique, medication adherence, and to
detect comorbidities that can contribute to symptom burden and poor quality of life. A
valuable tool for assessing the degree of symptom control is the Asthma Control Test
(ACT). Fraction of exhaled nitric oxide (FeNO) is a noninvasive method which enables to
evaluate the degree of airway inflammation in asthma.
Objective: The aim of this study was to evaluate the values of ACT and FeNO in
assessing asthma control and treatment efficacy, and to evaluate the correlation between
ACT and FeNO results.
Methods: The study included 39 patients (22 women (56%) and 17 men (44%)), average
age of 51 ± 16.7 years with uncontrolled asthma according to the Global Strategy
for Asthma Management and Prevention (GINA), who required step-up treatment. Each
subject completed the ACT and FeNO testing was performed. At the follow-up visit, which
occurred at least one month after the treatment correction, ACT and FeNO testing
were repeated.
Results: The mean initial ACT value was 15.5 ± 16.7, and the mean control ACT value
was 22.5 ± 3.5 (p< 0.01). The mean initial FeNO test value was 109.2 ± 63.7 ppb and the
mean control FeNO value was 59.3 ± 47.7 ppb (p<0.01). No statistically significant
correlation was found between initial and control ACT and FeNO results (p = 0.116 and
0.378, respectively).
Conclusion: Our study has shown that ACT and FeNO values improved significantly
after step-up treatment. Although no significant correlation was found between ACT and
FeNO values, those are valuable parameters, each measuring a different aspect of
asthma. Their combination, together with other clinical data, allows better assessment
and monitoring of astma.
.

• Keywords: astma; upitnik o kontroli astme; frakcija izdahnutoga dušikovog oksida
• Keywords (english): asthma; Asthma Control Test; Fraction of exhaled nitric oxide
• Language: croatian
• URN:NBN: urn:nbn:hr:105:087708
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-09 13:03:17