Choi S H, Yoo Y, Yu J, Rhee C-S, Min Y-G, Koh Y Y
Department of Pediatrics, Seoul National University Hospital, Seoul, Korea.
Allergy. 2007 Sep;62(9):1051-6. doi: 10.1111/j.1398-9995.2007.01403.x.
Subjects with allergic rhinitis but no clinical evidence of asthma have greater bronchial hyperresponsiveness (BHR), and several factors have been implicated as its determinants. However, studies in young children are lacking. The aims of this study were to evaluate the prevalence of BHR in young children with allergic rhinitis and to investigate its risk factors.
Methacholine bronchial challenges were performed in 4- to 6-year-old nonasthmatic children with allergic rhinitis (n = 83) and in healthy nonatopic controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Subjects were considered to have BHR when they had end-point concentrations of methacholine <or=8 mg/mL. Clinical and laboratory data in allergic rhinitis patients and a history of allergic diseases in their parents were collected.
BHR was observed in 27 subjects with allergic rhinitis (32.5%) and three controls (9.4%). Among subjects with allergic rhinitis, serum total IgE, the number and pattern of skin-prick test responses, blood eosinophil markers, and parental history of allergic rhinitis and atopic dermatitis were not different between the BHR(+) and BHR(-) groups, whereas the persistent type of rhinitis and parental history of asthma were more frequent in the BHR(+) group than in the BHR(-) group. These associations remained significant in a multivariable logistic regression.
Young children with allergic rhinitis alone showed an increased prevalence of BHR. Both persistent type of rhinitis and parental history of asthma were significant and independent risk factors for BHR in these children.
患有变应性鼻炎但无哮喘临床证据的受试者具有更高的支气管高反应性（BHR），并且有多种因素被认为是其决定因素。然而，针对幼儿的研究较少。本研究的目的是评估变应性鼻炎幼儿中BHR的患病率，并调查其危险因素。
采用改良听诊法对4至6岁的变应性鼻炎非哮喘儿童（n = 83）和健康非特应性对照儿童（n = 32）进行乙酰甲胆碱支气管激发试验。终点定义为出现喘息和/或氧饱和度下降。当受试者的乙酰甲胆碱终点浓度≤8 mg/mL时，被认为具有BHR。收集变应性鼻炎患者的临床和实验室数据以及其父母的过敏性疾病史。
在27名变应性鼻炎受试者（32.5%）和3名对照者（9.4%）中观察到BHR。在变应性鼻炎受试者中，BHR（+）组和BHR（-）组之间的血清总IgE、皮肤点刺试验反应的数量和模式、血液嗜酸性粒细胞标志物以及父母的变应性鼻炎和特应性皮炎病史无差异，而持续性鼻炎类型和父母哮喘病史在BHR（+）组中比在BHR（-）组中更常见。在多变量逻辑回归中，这些关联仍然显著。
仅患有变应性鼻炎的幼儿显示出BHR患病率增加。持续性鼻炎类型和父母哮喘病史都是这些儿童BHR的重要且独立的危险因素。
