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支气管扩张试验在变应性鼻炎患者中的应用。

Bronchodilation test in patients with allergic rhinitis.

机构信息

Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Italy.

出版信息

Allergy. 2011 May;66(5):694-8. doi: 10.1111/j.1398-9995.2011.02544.x. Epub 2011 Jan 25.

Abstract

BACKGROUND

Allergic rhinitis (AR) may be considered a risk factor for the onset of asthma. Recently, it has been reported that forced expiratory flow between 25% and 75% of vital capacity (FEF₂₅₋₇₅) may predict a positive response to bronchodilation test in asthmatic children. The aim of this study was to evaluate a large group of adult AR patients to investigate the frequency of response to bronchodilation test and FEF₂₅₋₇₅ values.

METHODS

One thousand four hundred and sixty-nine consecutive patients suffering from persistent AR were evaluated. Clinical examination, spirometry, and bronchodilation test were performed in all patients.

RESULTS

In this study, 62.9% of patients had reversibility to bronchodilation test and 17.8% had impaired FEF₂₅₋₇₅ values (≤ 65% of predicted). Impaired FEF₂₅₋₇₅ values associated with longer rhinitis duration may predict reversibility to bronchodilation test (OR = 11.3; P < 0.001). In addition, a FEF₂₅₋₇₅ cutoff value ≤ 71% of predicted may already discriminate patients with reversibility.

CONCLUSIONS

This study highlights that about two-thirds of patients with persistent AR may be considered at risk of becoming asthmatic. This finding should be adequately considered as a precocious spirometry may allow the early detection of patients prone to develop asthma and consequently to treat them.

摘要

背景

变应性鼻炎(AR)可被视为哮喘发病的危险因素。最近有报道称,用力呼气流量在 25%至 75%肺活量之间(FEF₂₅₋₇₅)可能预测哮喘儿童支气管扩张试验的阳性反应。本研究旨在评估一大群成年 AR 患者,以调查支气管扩张试验的反应频率和 FEF₂₅₋₇₅值。

方法

评估了 1469 例持续性 AR 连续患者。所有患者均进行临床检查、肺量测定和支气管扩张试验。

结果

在这项研究中,62.9%的患者对支气管扩张试验有反应,17.8%的患者存在 FEF₂₅₋₇₅值受损(≤预测值的 65%)。鼻炎持续时间较长与 FEF₂₅₋₇₅值受损相关,可能预测支气管扩张试验的反应性(OR = 11.3;P < 0.001)。此外,FEF₂₅₋₇₅截断值≤预测值的 71%可能已经可以区分有反应性的患者。

结论

本研究强调,约三分之二的持续性 AR 患者可能被认为有患哮喘的风险。这一发现应得到充分考虑,因为早期肺量测定可能允许早期发现易患哮喘的患者,并对其进行治疗。

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