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一次耳鼻喉科就诊会引发对儿童过敏性鼻炎的怀疑吗?

Can an otorhinolaryngological visit induce the suspect of allergic rhinitis in children?

作者信息

Ameli F, Tosca M A, Licari A, Gallo F, Ciprandi G

机构信息

Otorhinolaryngology Unit, Casa di Cura Villa Montallegro, Genoa, Italy.

Pediatric Allergy Center, Istituto G. Gaslini, Genoa, Italy.

出版信息

Eur Ann Allergy Clin Immunol. 2019 Nov;51(6):273-282. doi: 10.23822/EurAnnACI.1764-1489.105. Epub 2019 Oct 8.

Abstract

Allergic rhinitis (AR) is very frequent in childhood. AR is commonly associated with some co-morbidities and typical clinical features. This study aimed to test the hypothesis whether an otorhinolaryngological (ORL) visit could induce the suspect of AR. Globally, 1,002 children (550 males, mean age 5.77 years) were consecutively visited at an ORL clinic. Clinical visit, nasal endoscopy, and skin prick test were performed in all patients. In particular, history investigated atopic familiarity, birth, feeding type, passive smoking, comorbidities, including asthma, respiratory infections, otitis media, respiratory sleep disorder. Endoscopy assessed the tonsil and adenoid volume, turbinate contacts, mucosal color, and nasal discharge. Univariate and multivariate analysis were performed. The study showed that 547 (54.6%) children had AR. Some parameters were predicting factor for suspecting AR: middle turbinate contact (OR = 9.27), familial atopy (OR = 6.24), pale nasal mucosa (OR = 4.95), large adenoid volume (OR = 3.02 for score 4), and asthma co-morbidity (OR = 2.95). In conclusion this real-life study showed that during an ORL visit it is possible to suspect AR in children with turbinate hypertrophy, familial atopy, nasal pale mucosa, adenoid enlargement, and asthma comorbidity.

摘要

变应性鼻炎(AR)在儿童中非常常见。AR通常与一些合并症和典型临床特征相关。本研究旨在检验耳鼻喉科(ORL)就诊是否会引发对AR的怀疑这一假设。在全球范围内,1002名儿童(550名男性,平均年龄5.77岁)在一家耳鼻喉科诊所接受了连续就诊。所有患者均进行了临床检查、鼻内镜检查和皮肤点刺试验。特别是,病史调查了特应性家族史、出生情况、喂养方式、被动吸烟、合并症,包括哮喘、呼吸道感染、中耳炎、呼吸睡眠障碍。鼻内镜检查评估了扁桃体和腺样体体积、鼻甲接触情况、黏膜颜色和鼻分泌物。进行了单因素和多因素分析。研究表明,547名(54.6%)儿童患有AR。一些参数是怀疑AR的预测因素:中鼻甲接触(比值比[OR]=9.27)、家族性特应性(OR=6.24)、鼻黏膜苍白(OR=4.95)、腺样体体积大(评分4时OR=3.02)和哮喘合并症(OR=2.95)。总之,这项实际研究表明,在耳鼻喉科就诊期间,对于患有鼻甲肥大、家族性特应性、鼻黏膜苍白、腺样体肿大和哮喘合并症的儿童,有可能怀疑其患有AR。

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