Başak Ceylan DEMİRBAŞ, Şükrü ÇEKİÇ, Yakup Canıtez, Nihat Sapan

Okul çağındaki astımlı olguların çocukluk çağı astım kontrol testi ile değerlendirilmesi

GİRİŞ ve AMAÇ: Astım çocukluk çağında en sık görülen kronik hastalıktır. Mevsimsel değişikliklerin, astım atak sayıları ve hastalığın kontrol altında olma durumunu etkilediği bilinmektedir. BU çalışmada astım tanılı 6-11 yaş arasındaki olguların çocukluk çağı astım kontrol testi (Ç-AKT) ile değerlendirilmesi ve astım kontrolünü etkileyen faktörlerin belirlenmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Çalışmaya astım tanısıyla takipli 6-11 yaş arası 103 olgu alındı. Olgulardan Çocukluk Çağı Astım Kontrol Testi (Ç-AKT) ve tarafımızca hastaların değerlendirilmesi için düzenlenen astımlı anketini doldurmaları istendi. BULGULAR: Çocukluk çağı astım kontrol testi (Ç-AKT) sonucuna göre olguların %47,5’inin (n=49) kontrol altında olduğu saptandı. Kontrol altında olan grupta yıllık atak sayısı (medyan=2/yıl, minimum=0/yıl, maksimum=10/yıl) kontrol altında olmayan gruba göre ( medyan=3,5/yıl, minimum=0/yıl, maksimum=10/yıl) anlamlı olarak azdı (p=0,005). Kontrol altında olan olguların %14,3’ünün (n=7), kontrol altında olmayan olguların %38,9’unun (n=21) ailesinde egzama öyküsü olduğu tespit edildi (p=0,005). Hastaneye başvuru oranları kontrol altında olan olgularda: Eylül ayında %30,6 (n=15), Ekim ayında %32,7 (n=16), Kasım ayında %30,6 (n=15) ve Aralık ayında %6,10 (n=3); kontrol altında olmayan olgularda Eylül ayında %5,6 (n=3), Ekim ayında %25,9 (n=14), Kasım ayında %33,3 (n=18) ve Aralık ayında %35,2 (n=19) olarak saptandı. Aralık ayında kontrol altında olmayan olguların, kontrol altında olan olgulara göre daha sık başvurduğu tespit edildi (p=0,001). TARTIŞMA ve SONUÇ: Astım kontrol testleri hastaların takiplerinde hekimlere yardımcı olan pratik bir uygulamadır. Çalışma sonucunda astımlı hastaların önemli bir kısmının kontrol altında olmadığı görüldü. Astımlı olgularda Aralık ayında yakınmalarda görülen artışın bölgesel iklim değişiklikleri ve çevresel faktörlere bağlı olabileceği düşünüldü. Evaluation of school age asthmatic cases with childhood asthma control test INTRODUCTION: Asthma is the most common chronic disease in children. It is known that seasonal changes affect the number of asthma attacks and the condition of the disease under control as well. We evaluated children aged 6-11 years of age who had been diagnosed with asthma using the childhood asthma control test (C-ACT) to determine the factors affecting the control of asthma. METHODS: One hundred and three follow-up cases diagnosed with asthma between the ages of 6–11 were included. All cases were asked to fill in the C-ACT and the asthmatic questionnaire that we had prepared to evaluate the patients. RESULTS: It was determined that the 47.5% of the cases (n=49) were under control according to the results of the C-ACT. The number of annual attacks in the group under control (median=2/year, minimum=0/year,maximum=10/year) was significantly less than for the uncontrolled cases (median=3.5/year, minimum=0/year, maximum=10/year) (p=0.005). We determined that 14.3% (n=7) of the families of the group under control and 38.9% (n=21) of the families of the uncontrolled cases had a history of eczema (p=0.005). The hospital admission rates of the group under control were found to be 30.6% (n=15) in September, 32.7% (n=16) in October, 30.6% (n=15) in November, and 6.10% (n=3) in December, and the rates for the uncontrolled cases were 5.6% (n=3) in September, 25.9% (n=14) in October, 33.3% (n=18) in November, and 35.2% (n=19) in December. We detected that the uncontrolled cases were admitted more frequently than the ones under control in December (p=0.001). DISCUSSION AND CONCLUSION: C-ACT is a practical application that helps physicians with the follow-up of patients. We have determined in our study that a significant percentage of the asthmatics are uncontrolled cases. We estimated that the increase of complaints in December in patients with asthma may be related to regional climatic changes as well as environmental conditions.

Anahtar Kelimeler:

Astım, okul çağı, astım kontrol testi

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