| Objective: To investigate the evaluation role of small airway function on the control level of asthma patients before and after treatment, and analysis its related factors.Methods: Retrospective analysis method was used, according to the asthma diagnosis and grading standards of GINA, 81 severe asthma out-patients were selected out. Detected the pulmonary function, and divided the 81 patients into 3 groups according to pulmonary function: group A: FEV1 were <80% predicted before and after treatment (28 cases); group B: before treatment FEV1 <80% predicted value, but after 3 months treatment FEV1≥80% predicted value (27 cases); group C: FEV1 were≥80% predicted value before and after treatment (26 cases). Inclusion criteria: All the patients were treated with Salmeterol/fluticasone 50/250μg, 1 suction/time, 2 times daily for 12 months follow the level treatment of GINA. After 12 months, the treatment program changed to Salmeterol/fluticasone 50/100μg, 1 suction/time, 1 times daily on all the patients. The follow up was conducted at the 3rd, 6th, 9th and 12thmonth, all the patients achieved complete control without activity limitation according to the Asthma Control Test (ACT), and the pulmonary function was detected at the same time. There is no acute asthma attacks happened during the follow up. 1. Respiratory infections during the 12 months were statistic. 2. Compare the pulmonary function before and after treatment in A, B and C groups. 3. Statistical analysis:①Compare the difference of pulmonary function (FEV1, MMEF, FEF50%, FEF75%) in A, B, C three groups before and 12months after treatment respectively by Paired t-Test.②The correlation between the gender, age, disease duration, respiratory tract infections during the 12 months and FEV 1, MMEF, FEF50%, FEF75% were conducted by Regression Analysis.③Compare the difference of A, B, C three groups in age, duration, frequency of respiratory tract infection within 1 year by one way ANOVA.Results:①Before treatment, in group A and B, FEV1 <80% predicted value, small airway function were also <65% predicted; in group C, FEV1≥80% predicted value, and only 10 cases (38.46%), small airway function≥65% predicted value, while the other 16 cases (61.54%), small airway function <65% predicted. After treatment, in group A, FEV1 <80% predicted, the small airway function <65% predicted value; in group B, although the FEV1≥80% predicted value, 11 Cases (40.74%) small airway function≥65% predicted, 16 patients(59.26%) small airway function <65% predicted value; in group C, FEV 1were also≥80% predicted value, 21 patients (80.65% ) small airway function> 65% predicted value, 5 cases (19.35%) small airway function <65% predicted value.②After treatment for 12 months, the FEV1, MMEF, FEF50%, FEF75% in A, B and C three groups were significantly improved (P<0.05) compared with the same group before treatment. Before treatment, the pulmonary function (FEV1, MMEF, FEF50%, FEF75%) in group A were worse than group B and C (P<0.05), and group B were worse than group C (P<0.05); after treatment for 12 months, the pulmonary function (FEV1, MMEF, FEF50%, FEF75%) in group A were also worse than group B and C (P<0.05) and group B were still worse than group C (P<0.05).③The age, course and infection frequency and MMEF, FEF50%, FEF75% have negative correlation (r =- 0.665, -0.565, -0.574, P <0.05; B =- 0.948, -0.462, -0.738, P <0.05 and r =- 0.576, -0.878, -0.450, P <0.05, respectively), and the gender was independent from MMEF, FEF50%, FEF75% (P< 0.05).③The age in group A was statistically significant older compared with group B and C(P<0.05), group B was older than group C(P<0.05); the course in group A was longer than group B and C(P<0.05), group B had longer duration compared with group C(P<0.05); the number of respiratory tract infections in group A was more than group B and C(P <0.05), and in group B, the respiratory tract infections were more frequently than group C(P<0.05).Conclusion:①MMEF, FEF50%, FEF75% combined with FEV1 can be a better way to assess the control level of asthma patients.②MMEF, FEF50%, FEF75% combined with FEV1 can help evaluate treatment effect in asthma patients.③Age, disease course and frequency of respiratory tract infection had negative correlation with small airway function.
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