南京地区支气管哮喘患者合并过敏性鼻炎的现状及其临床表现相关性

背景:过敏性鼻炎和支气管哮喘均为呼吸道炎性疾病,它们常并存于同一患者。目的:了解南京地区支气管哮喘患者中过敏性鼻炎的发生率,并分析过敏性鼻炎与支气管哮喘在临床表现方面的相关性。设计:问卷调查。单位:解放军南京军区南京总医院耳鼻咽喉-头颈外科及呼吸内科。对象:纳入2001-02/2005-04解放军南京军区南京总医院确诊为支气管哮喘的患者134例,男73例,女61例;年龄3～72岁。参照全球哮喘防治创议(Global initiative for asthma,GINA)方案进行哮喘严重程度分级;过敏性鼻炎的诊断标准参照1997-11"海口会议"的修订标准;所有患者均同意参与问卷调查。方法:通过问卷调查,详细了解134例支气管哮喘患者中患支气管哮喘、过敏性鼻炎患者的年龄、症状分型及严重程度、治疗状况、家族史等临床资料。应用统计学描述和两个独立样本的t检验,并计算支气管哮喘合并过敏性鼻炎的发生率,比较支气管哮喘和过敏性鼻炎患者的年龄、发病年龄及病程的差异有无显著性。应用Spearman等级相关分析进行两者严重程度相关性分析。主要观察指标:支气管哮喘患者中过敏性鼻炎的发生率,以及过敏性鼻炎与支气管哮喘在临床表现方面的相关性。结果:支气管哮喘患者134例中82例(61.2%,82/134)并发过敏性鼻炎,其中男45例,女37例。此82例患者中,哮喘严重程度一级(轻度间歇)56例,二级(轻度持续)21例,三级(中度持续)4例,四级(重度持续)1例。其过敏性鼻炎分型,间歇性65例,持续性17例;按严重程度分级,轻度63例,中-重度19例。过敏性鼻炎与支气管哮喘严重程度呈明显正相关(r=0.689,P<0.01)。结论:南京地区支气管哮喘合并过敏性鼻炎的发生率较高;过敏性鼻炎与支气管哮喘严重程度具有高度相关性。

Status of patients with allergic rhinitis combined with bronchial asthma in Nanjing and the correlation of clinical characteristics

BACKGROUND: Both Allergic rhinitis and bronchial asthma are allergic diseases of respiratory tract. They frequently coexist in the same patients.OBJECTIVE: To study the incidence of allergic rhinitis in patients with bronchial asthma in Nanjing, and to analyze the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.DESIGN: The questionnaire survey.SETTING: Department of Otorhinolaryngology-Head and Neck Surgery and Department of Respiratory, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 134 patients with bronchial asthma including 73 males and 61 females were selected form Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from February 2001 to April 2005. Their ages ranged from 3 to 72 years. Severity of asthma of all patients was classified based on Global Initiative for Asthma (GINA). The diagnostic criteria of allergic rhinitis were established referred to the guideline of Haikou Meeting (November, 1997). All patients provided the confirmed consent.METHODS: The questionnaire survey of 134 bronchial asthma patients from the city of Nanjing was conducted. Their age, classification, severity, treatment status, and the family history of all 134 patients were investigated in details. Differences of age, age at onset, and course of disease between rhinitis and asthma of all patients were examined by two independent t tests. The correlation between clinical characteristics of allergic rhinitis and bronchial asthma was analyzed by Spearman rank correlation.MAIN OUTCOME MEASURES : Incidence of allergic rhinitis in patients with bronchial asthma and the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.RESULTS：Of all 134 bronchial asthma patients，82(61．2％,82/134)were accompanied with allergic rhinitis．There were 45 males and 37 females． Of 82 patients with allergic rhinitis accompanying with bronchial asthma，severity was classified into grade Ⅰ (mild pause,n=56)，grade Ⅱ (mild persistence，n=21)，grade Ⅲ (moderate persistence，n=4)，and grade Ⅳ (severe persistence，n=1)．In addition, allergic rhinitis was classified into periodicity (n=65) and persistence(n=17)．According to the classification and seventy system recommended in ARIA,63 patients had mild symptoms and 19 had moderate and severe symptoms．Severity of allergic rhinitis was positively related to that of bronchial asthma(r=0.689,P＜0．01)．CONCLUSION: The morbidity of allergic rhinitis combining with bronchial asthma is high in Nanjing, China. While, their classification and severity are highly coherent.