Castillo José Antonio, Navarro Ana, Quirce Santiago, Molina Jesús, García-Marcos Luis, Juliá Berta, Valero Antonio, Mullol Joaquim
Servei de Pneumologia, Institut Universitari Dexeus, Barcelona, España.
Med Clin (Barc). 2011 Mar 19;136(7):284-9. doi: 10.1016/j.medcli.2010.07.007. Epub 2010 Nov 2.
Rhinitis and asthma are linked by common epidemiological, clinical and inflammatory features. The objective of the AIR study was to understand the prevalence and characteristics of rhinitis in adult asthmatic patients who were seen in either primary or secondary care (Allergy or Pulmonology) in Spain.
This was a prospective epidemiological study with the participation of 1,369 randomly selected physicians. Five thousand six hundred sixteen asthmatic patients older than 18 years of age were selected and the study was carried out between February-September 2006. Demographic data, rhinitis prevalence, pulmonary function, allergy tests and treatments were analyzed.
Some 75% (N=4,212) of the asthmatic patients presented with additional rhinitis and these were characterised as being both younger (41.3 vs 50.4 years; p<0.0001) and with less severe asthma (FEV(1)=86.6 vs 79.3%, p<0.0001) than asthmatic patients without rhinitis. A positive correlation was found between asthma and rhinitis severity (p<0.0001) whilst atopy was significantly associated with the presence of rhinitis (81 vs 48%; OR: 4.80; CI 95%: 4.2-5.5). The presence of co-morbid rhinitis was associated with a higher number of asthma exacerbations (p<0.001).
Some 75% of our asthmatic patients had associated rhinitis and this association was more frequent in atopic subjects. There is a positive correlation between the severity of rhinitis and asthma and between the number of asthma exacerbations and the presence of rhinitis. These results support the main message of ARIA and GEMA recommendations regarding the integral management of airways to improve the control of asthma.
鼻炎和哮喘在流行病学、临床及炎症特征方面存在共同之处。AIR研究的目的是了解在西班牙初级或二级医疗保健机构(过敏科或肺病科)就诊的成年哮喘患者中鼻炎的患病率及特征。
这是一项前瞻性流行病学研究,有1369名随机挑选的医生参与。选取了5616名18岁以上的哮喘患者,研究于2006年2月至9月进行。分析了人口统计学数据、鼻炎患病率、肺功能、过敏测试及治疗情况。
约75%(N = 4212)的哮喘患者还患有鼻炎,与无鼻炎的哮喘患者相比,这些患者更年轻(41.3岁对50.4岁;p < 0.0001),哮喘病情也较轻(第一秒用力呼气容积[FEV₁]=86.6%对79.3%,p < 0.0001)。发现哮喘与鼻炎严重程度之间存在正相关(p < 0.0001),而特应性与鼻炎的存在显著相关(81%对48%;比值比:4.80;95%置信区间:4.2 - 5.5)。合并鼻炎与更多的哮喘发作相关(p < 0.001)。
约75%的哮喘患者伴有鼻炎,这种关联在特应性个体中更常见。鼻炎严重程度与哮喘严重程度之间以及哮喘发作次数与鼻炎的存在之间存在正相关。这些结果支持了变应性鼻炎及其对哮喘的影响(ARIA)和全球哮喘防治创议(GEMA)关于气道综合管理以改善哮喘控制的主要观点。