Krefting Research Centre, Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Respir Med. 2011 Nov;105(11):1611-21. doi: 10.1016/j.rmed.2011.06.004. Epub 2011 Jul 18.
Asthma and rhinitis frequently coexist, but no population study has previously determined the relationship between nasal comorbidities and symptom expression and risk factors of asthma.
In 2008, a postal questionnaire on respiratory health was sent to 30,000 randomly selected subjects aged 16-75 years in West Sweden; 29218 could be traced and 18,087 (62%) responded. The questionnaire included questions on asthma, rhinitis, chronic rhinosinusitis, respiratory symptoms and possible determinants.
Prevalence of allergic rhinitis in asthma was 63.9% and of asthma in allergic rhinitis 19.8%. Prevalence of chronic rhinosinusitis in asthma was 8.4% and of asthma in chronic rhinosinusitis 24.4%. Asthma subjects with chronic rhinitis, or chronic rhinosinusitis, had more symptoms of asthma and bronchitis than those without rhinitis (p < 0.001). There was an obvious trend of higher ORs for various environmental exposures including occupational exposure to dust, gases and fumes (OR 2.32 vs. OR 1.44), visible mould at home (OR 1.72 vs. OR 1.27) and water damage at home (OR 1.82 vs. OR 1.06) for asthma with chronic rhinosinusitis than for asthma with allergic rhinitis. Family history of allergy yielded a higher OR for asthma with allergic rhinitis than with asthma with chronic rhinosinusitis (OR 7.15 vs. OR 4.48).
Considerable overlap between asthma and nasal comorbidities was documented, confirming a close relationship between nasal disease and asthma. Allergic rhinitis, chronic rhinitis and chronic rhinosinusitis were associated with different risk factor patterns and symptom expression of asthma. Thus, different nasal comorbidities may reflect different phenotypes of asthma.
哮喘和鼻炎经常同时存在，但以前没有人群研究确定过鼻部合并症与哮喘的症状表现和风险因素之间的关系。
2008 年，在瑞典西部向 30000 名随机选择的 16-75 岁的受试者邮寄了一份关于呼吸健康的调查问卷；可追踪到 29218 人，其中 18087 人（62%）做出了回应。调查问卷包括哮喘、鼻炎、慢性鼻-鼻窦炎、呼吸道症状和可能的决定因素等问题。
哮喘患者中过敏性鼻炎的患病率为 63.9%，过敏性鼻炎患者中哮喘的患病率为 19.8%。哮喘患者中慢性鼻-鼻窦炎的患病率为 8.4%，慢性鼻-鼻窦炎患者中哮喘的患病率为 24.4%。有慢性鼻炎或慢性鼻-鼻窦炎的哮喘患者，其哮喘和支气管炎症状比没有鼻炎的患者更多（p<0.001）。对于各种环境暴露，包括职业性暴露于粉尘、气体和烟雾（比值比 2.32 比 1.44）、家中可见霉菌（比值比 1.72 比 1.27）和家中水渍（比值比 1.82 比 1.06），哮喘伴慢性鼻-鼻窦炎的患者明显比哮喘伴过敏性鼻炎的患者比值比更高。对于哮喘伴过敏性鼻炎，家族过敏史的比值比高于哮喘伴慢性鼻-鼻窦炎（比值比 7.15 比 4.48）。
哮喘和鼻部合并症之间存在相当大的重叠，这证实了鼻部疾病与哮喘之间的密切关系。过敏性鼻炎、慢性鼻炎和慢性鼻-鼻窦炎与哮喘的不同风险因素模式和症状表现相关。因此，不同的鼻部合并症可能反映了哮喘的不同表型。
