Ciprandi Giorgio, Klersy Catherine, Ameli Franco, Cirillo Ignazio
Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
Am J Rhinol. 2008 Sep-Oct;22(5):502-5. doi: 10.2500/ajr.2008.22.3214.
Nasal airflow, as measured by rhinomanometry, is frequently impaired in allergic rhinitis (AR). The decongestion test evaluates whether the application of an intranasal vasoconstrictor drug increases nasal airflow. That allergy is characterized by inflammation and that the response to the decongestion test correlates with the grade of inflammatory reaction has previously been shown. The aim of this study was to verify the suitability of the use of the visual analog scales (VASs) as a surrogate for rhinomanometry in the decongestion test assessment in patients with persistent allergic rhinitis.
One hundred three patients (mean age, 23 years [2.24 SD]) were studied. Nasal symptoms, VAS, rhinomanometry, and nasal decongestion test were assessed in all patients.
A significant association was observed between VAS and nasal airflow after the decongestion test (Spearman R = -33.3%; p < 0.001). Moreover, a significant inverse association between changes in decongestion measures was detected, with a Spearman R = -64.7% (p < 0.001). The associated sensitivity was of 92.5%, and the specificity for this test was 60.0%. The corresponding area under the receiver operating characteristic curve was 0.81.
The use of VAS for assessing the decongestion test appears clinically relevant in that it allows, with a fair degree of reliability, such a test to be performed in the absence of rhinomanometry.
通过鼻阻力计测量的鼻气流在过敏性鼻炎(AR)中经常受损。鼻充血试验评估鼻内血管收缩药物的应用是否能增加鼻气流。先前已表明,过敏以炎症为特征,且对鼻充血试验的反应与炎症反应程度相关。本研究的目的是验证在持续性过敏性鼻炎患者的鼻充血试验评估中,使用视觉模拟量表(VAS)替代鼻阻力计的适用性。
对103例患者(平均年龄23岁[标准差2.24])进行研究。对所有患者评估鼻症状、VAS、鼻阻力计和鼻充血试验。
鼻充血试验后,观察到VAS与鼻气流之间存在显著相关性(Spearman相关系数R = -33.3%;p < 0.001)。此外,在鼻充血测量的变化之间检测到显著的负相关,Spearman相关系数R = -64.7%(p < 0.001)。该试验的相关敏感度为92.5%,特异度为60.0%。受试者工作特征曲线下的相应面积为0.81。
使用VAS评估鼻充血试验在临床上似乎具有相关性,因为它能够在没有鼻阻力计的情况下以相当程度的可靠性进行该试验。