Daily Monitoring Of Peak Expiratory Flow Affect The Level Of Asthma Control And Reduce The Risk Of Acute Asthma Exacerbations

Objective: Bronchial asthma (asthma) is a chronic inflammatory disease of theairways, its morbidity and mortality showed a rising trend year by year, it has nowbecome the worldwide growing concern about public health problem. However, thecurrent status quo of the global asthma control is not optimistic. How to better controlasthma and reduce the risk of asthma exacerbation?2009GINA Guide (GlobalInitiative for Asthma) proposed the goal of asthma treatment is to achieve andmaintain asthma control. Peak expiratory flow (PEF) as an objective lung functionsimple indicator, and Peak expiratory flow rate (PEFR) are used clinically to assessand monitor the level of asthma control, and to guide the adjustment of the asthmatreatment plan. The purpose of this study is to analyze the impact of the dailymonitoring of PEF on the level of asthma control and reduce the risk of acute asthmaexacerbation.Methods:21asthmatic patients went to the First Affiliated Hospital of DalianMedical University for treatment in November2010to May2011, and they had beenstandardized treatment for more than1year. Including10males (47.62%) and11females (52.38%), mean age (36.38±10.21) years, mean disease duration (9.67±5.35) years. The patients received face-to-face questionnaire and daily monitoring ofPEF a year, filled asthma diaries and the questionnaire of asthma control test (ACT).The level of asthma control,frequency of asthma acute exacerbations, and the rate ofhospitalization,number of emergency treatments,lost working days due to asthmaexacerbations were compared between monitoring PEF and no monitoring PEF. Theresults of PEF were compared with the results of ACT,and the future risk of acuteasthma exacerbation was assessed. Results:47.62%of asthmatic patients achieved controlled and33.33%achievedpartly controlled by monitoring PEF,these were significantly higher than nomonitoring PEF (P＜0.05). During the monitoring PEF1year, the rate ofhospitalization,number of emergency treatments,and lost working days due to asthmaexacerbations were9.52%、14.29%、19.05%, these were significantly lower than nomonitoring PEF (P＜0.05). ACT score of green region group was significantly higherthan red region group,or ACT score of yellow region group also was significantlyhigher than red region group(P＜0.05);but there was no significant difference of ACTscore between green region group and yellow region group(P=0.221). During themonitoring PEF1year, PEF%pred of partly controlled group was significantly higherthan that of uncontrolled group(P＜0.05),and frequency of exacerbations at partlycontrolled group was significantly lower than that of uncontrolled group(P＜0.05).Conclusions:1.Daily monitoring of PEF can effectively improve the level ofasthma control.2. ACT questionnaire combined with dynamic monitoring of PEF may help tomore accurately reflect the real disease status of asthmatic patients.3. Daily monitoring of PEF can reduce the future risk of acute asthmaexacerbations.