Castillo Vizuete José Antonio, Mullol Miret Joaquim
Servei d'Allèrgia i Pneumologia, Institut Universitari Dexeus, Barcelona, España.
Arch Bronconeumol. 2008 Nov;44(11):597-603.
Rhinitis and asthma share an inflammatory mechanism, epidemiological patterns, and symptoms that affect both the nose and the bronchi. The RINAIR study examined the prevalence and characteristics of rhinitis in asthma patients in Spain.
This prospective epidemiological study was carried out with the participation of 15% of Spanish respiratory medicine specialists sampled randomly from different geographic areas. The study population was composed of 703 asthmatic patients aged over 16 years who were enrolled between February and September 2005. Patient characteristics, prevalence of rhinitis, lung function, allergy test results, and treatment of rhinitis were analyzed.
Seventy-one percent (n=499) of the asthmatic patients had rhinitis. These patients were younger (43.8 years vs 55.4 years; P< .0001) and had less severe asthma (forced expiratory volume in 1 second [FEV1], 85.7% vs 79.7% [P< .001]) than asthmatic patients who did not have rhinitis. A correlation was observed between the severity of asthma and the severity of rhinitis (P< .001). Atopy was significantly associated with rhinitis (odds ratio, 6.25; 95% confidence interval, 4.3-9.1): 84% of atopic patients and 51% of nonatopic patients had rhinitis. Treatment of rhinitis was associated with an increase in FEV1 (P=.057), irrespective of sex, age, severity of asthma, or smoking.
Seventy-one percent of asthmatic patients who attended respiratory medicine clinics had rhinitis. These patients were younger and had milder asthma than asthmatics who did not have rhinitis. Furthermore, atopy was correlated with asthma associated with rhinitis. Treatment of rhinitis led to improved lung function. These findings highlight the need to study and treat the upper and lower respiratory tract as a single airway.
鼻炎和哮喘具有共同的炎症机制、流行病学模式以及影响鼻子和支气管的症状。RINAIR研究调查了西班牙哮喘患者中鼻炎的患病率及特征。
这项前瞻性流行病学研究由从不同地理区域随机抽取的15%的西班牙呼吸内科专家参与进行。研究人群由2005年2月至9月招募的703名16岁以上的哮喘患者组成。分析了患者特征、鼻炎患病率、肺功能、过敏试验结果以及鼻炎治疗情况。
71%(n = 499)的哮喘患者患有鼻炎。与未患鼻炎的哮喘患者相比,这些患者更年轻(43.8岁对55.4岁;P <.0001),哮喘病情较轻(一秒用力呼气量[FEV1],85.7%对79.7%[P <.001])。观察到哮喘严重程度与鼻炎严重程度之间存在相关性(P <.001)。特应性与鼻炎显著相关(优势比,6.25;95%置信区间,4.3 - 9.1):84%的特应性患者和51%的非特应性患者患有鼻炎。鼻炎治疗与FEV1增加相关(P = 0.057),无论性别、年龄、哮喘严重程度或吸烟情况如何。
到呼吸内科诊所就诊的哮喘患者中有71%患有鼻炎。这些患者比未患鼻炎的哮喘患者更年轻,哮喘病情更轻。此外,特应性与伴有鼻炎的哮喘相关。鼻炎治疗可改善肺功能。这些发现凸显了将上呼吸道和下呼吸道作为一个气道进行研究和治疗的必要性。