Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
Am J Rhinol Allergy. 2013 Jan;27(1):e22-5. doi: 10.2500/ajra.2013.27.3846.
A relevant relationship exists between the upper and lower airway, indicating the concept of a unified airway. This study aimed to evaluate whether rhinitis has an association with asthma in children.
A cross-sectional nationwide survey was performed among children 6-7, 13-14, and 16-17 years old, using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire in Japan. According to the responses to the ISAAC core questions, a child who had experienced nasal symptoms in the past 12 months in the absence of a cold was defined as having current rhinitis.
After excluding 11,475 children because of incomplete data, 136,506 children were analyzed. Even after adjusting for demographics, sex, and obesity, children with current rhinitis were more likely to have asthma (adjusted odds ratio [OR], 3.10 [95% CI, 2.92-3.30] in children aged 6-7 years; OR, 3.76 [95% CI, 3.45-4.10] in children aged 13-14 years; and OR, 3.59 [95% CI, 3.33-3.88] in children aged 16-17 years). Children whose daily activities were more impaired by rhinitis symptoms had a significantly higher prevalence of severe asthma. The adjusted ORs for severe asthma among asthmatic children whose daily activities were severely impaired by rhinitis symptoms were 3.66 (95% CI, 2.29-5.85) in children aged 6-7 years, 2.55 (95% CI, 1.64-3.96) in children aged 13-14 years, and 1.87 (95% CI, 1.24-2.82) in children aged 16-17 years compared with asthmatic children whose daily activities were not impaired at all.
There was a close association between rhinitis and asthma in young children to adolescents. Asthma should be examined in children with rhinitis symptoms.
上下气道存在相关关系,提示气道统一的概念。本研究旨在评估儿童鼻炎是否与哮喘有关。
在日本,使用国际儿童哮喘和过敏研究(ISAAC)问卷对 6-7、13-14 和 16-17 岁儿童进行了一项横断面全国性调查。根据 ISAAC 核心问题的回答,在过去 12 个月内无感冒但出现鼻部症状的儿童被定义为患有持续性鼻炎。
排除 11475 名因数据不完整的儿童后,对 136506 名儿童进行了分析。即使在调整了人口统计学、性别和肥胖因素后,患有持续性鼻炎的儿童更有可能患有哮喘(调整后的优势比[OR],6-7 岁儿童为 3.10 [95%可信区间,2.92-3.30];13-14 岁儿童为 3.76 [95%可信区间,3.45-4.10];16-17 岁儿童为 3.59 [95%可信区间,3.33-3.88])。鼻炎症状对日常活动影响更大的儿童,其严重哮喘的患病率显著更高。鼻炎症状严重影响哮喘儿童日常活动的哮喘严重程度的调整 OR 为,6-7 岁儿童为 3.66(95%可信区间,2.29-5.85),13-14 岁儿童为 2.55(95%可信区间,1.64-3.96),16-17 岁儿童为 1.87(95%可信区间,1.24-2.82),与哮喘儿童的日常活动完全不受影响相比。
在幼儿至青少年中,鼻炎与哮喘密切相关。对于有鼻炎症状的儿童,应检查哮喘。