Hamouda S, Karila C, Connault T, Scheinmann P, de Blic J
Université Paris Descartes, Assistance Publique des hôpitaux de Paris, Hôpital Necker Enfants Malades, Service de Pneumologie et d'Allergologie Pédiatriques, Paris, France.
Clin Exp Allergy. 2008 May;38(5):761-6. doi: 10.1111/j.1365-2222.2008.02953.x. Epub 2008 Feb 25.
Allergic rhinitis (AR) and asthma frequently coexist but has rarely been evaluated in children.
This prospective study aimed to estimate the prevalence of AR in asthmatic children, and ascertain whether AR is a risk factor for the severity of asthma.
The questionnaire, modified from the adult form of the score for allergic rhinitis (SFAR), was completed by 404 asthmatic children aged 3-18 years seen in the outpatient clinic between June 2005 and July 2007. Each item was assigned a number of points with a final score ranging from 0 to 17. AR and asthma were classified according to ARIA and GINA 2004 recommendations, respectively.
AR was diagnosed in 237 patients (58.7%). It was intermittent in 57.8% of the patients and persistent in 42.2%. A total score >or=9 was discriminant for AR (sensitivity=91.1%, specificity=95.2%, positive predictive value=96.4%, negative predictive value=88.3%, Youden's Index=0.86). The proportion of children having mild or moderate-to-severe asthma was independent of the presence of AR, 61.6% of moderate-to-severe asthmatic children and 55.4% of intermittent and mild asthmatic children having AR.
AR and asthma are frequently associated (58.7%). The SFAR adapted for children seems to be a simple and a reliable tool to detect AR in asthmatic children.
变应性鼻炎(AR)和哮喘常并存,但在儿童中很少得到评估。
这项前瞻性研究旨在估计哮喘儿童中AR的患病率,并确定AR是否为哮喘严重程度的危险因素。
2005年6月至2007年7月期间,在门诊就诊的404名3至18岁哮喘儿童完成了一份根据成人变应性鼻炎评分(SFAR)修改的问卷。每个项目都被赋予一定分数,最终得分范围为0至17分。AR和哮喘分别根据2004年ARIA和GINA推荐进行分类。
237例患者(58.7%)被诊断为AR。其中57.8%为间歇性,42.2%为持续性。总分≥9分对AR具有判别意义(敏感性=91.1%,特异性=95.2%,阳性预测值=96.4%,阴性预测值=88.3%,约登指数=0.86)。患有轻度或中重度哮喘的儿童比例与AR的存在无关,61.6%的中重度哮喘儿童以及55.4%的间歇性和轻度哮喘儿童患有AR。
AR与哮喘常相关(58.7%)。适用于儿童的SFAR似乎是检测哮喘儿童中AR的一种简单且可靠的工具。