Stull Donald E, Schaefer Michael, Crespi Simone, Sandor David W
United BioSource Corporation, Center for Health Outcomes Research, London, UK.
Curr Med Res Opin. 2009 Jul;25(7):1785-92. doi: 10.1185/03007990903021968.
Nasal congestion associated with allergic rhinitis has been shown to be the most bothersome symptom. Ocular symptoms may be troublesome to patients as well.
To estimate the relative strength of relationships of nasal congestion and ocular symptoms associated with allergic rhinitis with patient-reported outcomes of sleep quality; practical problems; somnolence; impairment at work, class, activities; and mood.
Patients (n = 404) presenting with symptoms of allergic rhinitis completed five patient-reported outcomes that assessed the effect of morning allergic rhinitis symptoms on patients' reports of sleep, work and activity impairment, and mood. Multiple regression analyses were used to compare the relative strength of relationships of congestion and ocular symptoms with the patient-reported outcomes.
The majority of patients had both nasal congestion and ocular symptoms at baseline. A single nasal congestion item and a 3-item ocular symptom score were significantly related to the patient-reported outcomes: those with more severe congestion or ocular symptoms reported more negative scores on the patient-reported outcomes. Nasal congestion had the stronger relationship with patient-reported outcomes total scores or subscales in 14 of 20 regressions.
Although nasal congestion is generally more strongly related to the patient-reported outcomes, ocular symptoms have a significant negative effect on patients' lives. Study limitations include: (1) only baseline data were used because of greater severity and variability of symptoms scores; we are unable to establish causal relationships or discuss change, only correlation/covariation; (2) recruitment took place from September through November, thus different patients might have been recruited if sampling took place during the spring; (3) patients were screened for nasal congestion not for ocular symptoms, though there was high co-occurrence of each. These limitations aside, congestion and ocular symptoms are troublesome to patients and typically co-occur. Evaluating and treating these symptoms are key to managing allergic rhinitis and improving patient-reported outcomes.
变应性鼻炎相关的鼻充血已被证明是最困扰人的症状。眼部症状对患者来说也可能很麻烦。
评估变应性鼻炎相关的鼻充血和眼部症状与患者报告的睡眠质量、实际问题、嗜睡、工作、学习、活动中的功能损害以及情绪等结局之间关系的相对强度。
有变应性鼻炎症状的患者（n = 404）完成了五项患者报告结局评估，这些评估用于评价早晨变应性鼻炎症状对患者睡眠、工作及活动功能损害和情绪报告的影响。采用多元回归分析比较鼻充血和眼部症状与患者报告结局之间关系的相对强度。
大多数患者在基线时同时存在鼻充血和眼部症状。单个鼻充血条目和一个3项眼部症状评分与患者报告结局显著相关：鼻充血或眼部症状越严重的患者，在患者报告结局上的得分越负面。在20项回归分析中的14项中，鼻充血与患者报告结局总分或子量表的关系更强。
虽然鼻充血通常与患者报告结局的关系更强，但眼部症状对患者的生活有显著负面影响。研究局限性包括：（1）由于症状评分的严重程度和变异性较大，仅使用了基线数据；我们无法建立因果关系或讨论变化情况，只能讨论相关性/协变量关系；（2）招募时间为9月至11月，因此如果在春季进行抽样，可能会招募到不同的患者；（3）对患者进行鼻充血筛查而非眼部症状筛查，尽管两者同时出现的情况很常见。除了这些局限性外，鼻充血和眼部症状给患者带来困扰且通常同时出现。评估和治疗这些症状是管理变应性鼻炎和改善患者报告结局的关键。
