Dogru Mahmut, Evcimik Muhammed Fatih, Calim Omer Faruk
Department of Pediatrics, Zeynep Kamil Woman and Children's Diseases Training and Research Hospital, Burhanettin Ustunel Cad. No.10 Uskudar, Istanbul, Turkey.
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):209-213. doi: 10.1007/s00405-016-4196-x. Epub 2016 Jul 12.
Our study aims to evaluate the presence of adenoid hypertrophy (AH) in children with allergic rhinitis (AR) and the association of AH disease severity and clinical laboratory finding from retrospective, cross-sectional, and nonrandomized trial. The study included 566 children being treated and followed up for allergic rhinitis. Skin prick test for the same allergens was performed for all patients. Adenoid tissue was analyzed by an ENT specialist and the diagnosis was confirmed based on the patient history, endoscopic physical examination and radiology. Adenoid hypertrophy was detected in 118 (21.2 %) of the children with AR. Children with and without AH did not differ statistically and significantly by gender, age, presence of atopy in the family, exposure to smoke (p > 0.05). Comparison of the groups for AR duration demonstrated significantly higher frequency of persistent rhinitis in patients with AH (p < 0.05). Of the AR patients with AH, 90 (76.3 %) had moderate-severe rhinitis and 274 (62.6 %) AR patients without AH had moderate-severe rhinitis (p = 0.005). Itchy nose was more frequent in AR patients without AH, and nasal congestion was more common in AR patients with AH (p = 0.017 and p = 0.001, respectively). The presence of asthma was more common among AR patients without AH (p = 0.037). Intergroup comparisons for presence of atopic dermatitis, the percentage of eosinophil, serum IgE levels, the number of positive sensitivity, polysensitization, sensitivity to house dust mite, cockroach, pollens and dander yielded no significant difference (p > 0.05). On the other hand, sensitivity to Alternaria alternata was significantly more frequent in AR patients with AH (p = 0.032). The presence of AH increased the severity of the disease and prolongs disease duration. There was a negative relationship between AH and asthma in children with AR. AH is more common among children with mold sensitivity. AH should be considered and investigated particularly in non-asthmatic children with pronounced nasal congestion and A. alternata sensitivity.
我们的研究旨在通过回顾性、横断面和非随机试验，评估变应性鼻炎（AR）患儿腺样体肥大（AH）的存在情况，以及AH疾病严重程度与临床实验室检查结果之间的关联。该研究纳入了566名接受变应性鼻炎治疗和随访的儿童。对所有患者进行了相同变应原的皮肤点刺试验。由耳鼻喉科专家对腺样体组织进行分析，并根据患者病史、内镜体格检查和影像学检查确诊。在118名（21.2%）AR患儿中检测到腺样体肥大。有和没有AH的儿童在性别、年龄、家族中特应性疾病的存在、接触烟雾方面无统计学显著差异（p>0.05）。对AR病程的组间比较显示，AH患者持续性鼻炎的频率显著更高（p<0.05）。在有AH的AR患者中，90名（76.3%）患有中度至重度鼻炎，而274名（62.6%）没有AH的AR患者患有中度至重度鼻炎（p=0.005）。无AH的AR患者鼻痒更常见，有AH的AR患者鼻塞更常见（分别为p=0.017和p=0.001）。哮喘的存在在无AH的AR患者中更常见（p=0.037）。在特应性皮炎的存在、嗜酸性粒细胞百分比、血清IgE水平、阳性敏感性数量、多致敏、对屋尘螨、蟑螂、花粉和皮屑的敏感性方面，组间比较无显著差异（p>0.05）。另一方面，有AH的AR患者对链格孢的敏感性显著更常见（p=0.032）。AH的存在增加了疾病的严重程度并延长了病程。AR患儿中AH与哮喘之间存在负相关。AH在对霉菌敏感的儿童中更常见。对于有明显鼻塞和对链格孢敏感的非哮喘儿童，尤其应考虑并调查AH。
