Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino-University of Genoa, Italy.
Am J Rhinol Allergy. 2011 Mar-Apr;25(2):e72-6. doi: 10.2500/ajra.2011.25.3607.
Allergic rhinitis is considered a strong risk factor for the onset of asthma. However, few studies addressed this issue from a functional point of view. The aim of this study was to follow up a group of patients with allergic rhinitis to investigate the onset of possible spirometric abnormalities and/or bronchial hyperreactivity (BHR).
Eighty-nine patients with moderate-severe persistent allergic rhinitis were prospectively and consecutively evaluated; 940 controls were also included in the study. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients every 2 years for 8 years.
The number of patients with forced expiratory flow at 25 and 75% of pulmonary volume of <70% of predicted significantly increased during the observation time. At baseline, no subjects had BHR; whereas 34 patients had BHR after 8 years. Sensitization to mites, birch, and Parietaria as well as rhinitis duration are risk factors for these changes.
This study highlights the close link between upper and lower airways and suggests that spirometry should be performed in patients with allergic rhinitis.
过敏性鼻炎被认为是哮喘发病的一个强烈危险因素。然而，从功能角度探讨这一问题的研究较少。本研究旨在随访一组过敏性鼻炎患者，观察可能出现的肺功能异常和/或气道高反应性（BHR）的发生情况。
前瞻性连续评估 89 例中重度持续性过敏性鼻炎患者；同时纳入 940 例对照者。所有患者每 2 年进行一次临床检查、皮肤点刺试验、肺功能检查和乙酰甲胆碱激发试验，共 8 年。
观察期间，用力呼气流量在 25%和 75%肺活量时<预计值的 70%的患者数量显著增加。基线时，无患者出现 BHR；而 8 年后有 34 例患者出现 BHR。对螨、桦树和豚草过敏以及鼻炎持续时间是这些变化的危险因素。
本研究强调了上、下呼吸道之间的密切联系，并提示应在过敏性鼻炎患者中进行肺功能检查。
