变应性鼻炎和哮喘共病：变应性鼻炎的ARIA分类与哮喘患病率无关。

Allergic rhinitis and asthma comorbidity: ARIA classification of rhinitis does not correlate with the prevalence of asthma.

作者信息

Antonicelli L, Micucci C, Voltolini S, Feliziani V, Senna G E, Di Blasi P, Visonà G, De Marco R, Bonifazi F

机构信息

Allergy Unit, Department of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona, Italy.

出版信息

Clin Exp Allergy. 2007 Jun;37(6):954-60. doi: 10.1111/j.1365-2222.2007.02729.x.

DOI:10.1111/j.1365-2222.2007.02729.x

PMID:17517110

Abstract

BACKGROUND

Allergic rhinitis and asthma comorbidity is supported by both the similar underlying pathogenesis and immunologic mechanisms. The aim of this study was to verify whether the characteristics of rhinitis classified according to the new Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines correlate with the prevalence of asthma.

METHODS

From 1 March to 30 June 2002, a multi-centre cross-sectional study was conducted by 154 allergists chosen from throughout Italy. Duration, severity of rhinitis (according to the ARIA classification) and the type of allergic sensitizations were compared with the prevalence of asthma.

RESULTS

One thousand three hundred and twenty-one consecutive rhinitis-allergic patients aged 18 years or older were enrolled for the study. The majority of patients, 1060 (80.24%), were on medication at the time of their specialist visit. Mild intermittent rhinitis was diagnosed in 7.7% of patients, moderate/severe intermittent in 17.1%, mild persistent in 11.6%, and moderate/severe persistent in 63.6%. The prevalence of asthma was 48% in patients with mild intermittent rhinitis, 49.6% in moderate-severe intermittent rhinitis, 36.6% in mild persistent rhinitis and 47.5% in moderate severe persistent patients. No correlation between the ARIA categories of rhinitis and the prevalence of asthma was found. A multivariate analysis, after adjustment for age, sex, type of sensitization, level of severity and duration of rhinitis classified according to the ARIA guidelines, demonstrated that age, over 41 years [risk ratio (RR) 1.260, 95% confidence interval (CI) 1.072-1.482] and especially over 51 years (RR 1.460, 95% CI 1.237-1.723), sensitization to indoor allergens (mite and cat), (RR 1.203, 95% CI 1.060-1.366), and polysensitization (RR 1.178, 95% CI 1.004-1.383) are significant risk factors for asthma.

CONCLUSION

In allergic rhinitis (AR) patients referred to a specialist, the features of AR as defined by the ARIA classification are not able to predict the presence of asthma, therefore all such patients should be assessed for asthma.

摘要

背景

变应性鼻炎和哮喘共病有相似的潜在发病机制和免疫机制作为支撑。本研究的目的是验证根据变应性鼻炎及其对哮喘的影响（ARIA）新指南分类的鼻炎特征是否与哮喘患病率相关。

方法

2002年3月1日至6月30日，由从意大利各地挑选出的154名过敏症专科医生进行了一项多中心横断面研究。将鼻炎的病程、严重程度（根据ARIA分类）和变应性致敏类型与哮喘患病率进行比较。

结果

1321名年龄在18岁及以上的连续性鼻炎-变应性患者被纳入研究。大多数患者，即1060名（80.24%），在专科就诊时正在接受治疗。7.7%的患者被诊断为轻度间歇性鼻炎，17.1%为中度/重度间歇性鼻炎，11.6%为轻度持续性鼻炎，63.6%为中度/重度持续性鼻炎。轻度间歇性鼻炎患者的哮喘患病率为48%，中度-重度间歇性鼻炎患者为49.6%，轻度持续性鼻炎患者为36.6%，中度-重度持续性鼻炎患者为47.5%。未发现鼻炎的ARIA类别与哮喘患病率之间存在相关性。在根据ARIA指南对年龄、性别、致敏类型、严重程度级别和鼻炎病程进行调整后的多变量分析表明，年龄超过41岁[风险比（RR）1.260，95%置信区间（CI）1.072-1.482]，尤其是超过51岁（RR 1.460，95%CI 1.237-1.723）、对室内变应原（螨虫和猫）致敏（RR 1.203，95%CI 1.060-1.366）以及多重致敏（RR 1.178，95%CI 1.004-1.383）是哮喘的重要危险因素。