Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Charleston County School of the Arts, North Charleston, South Carolina, USA.
Int Forum Allergy Rhinol. 2021 Sep;11(9):1367-1377. doi: 10.1002/alr.22794. Epub 2021 Mar 27.
Rhinologists often encounter a broad spectrum of allergic rhinitis (AR) and nonallergic rhinitis (NAR) patients, who can be variably classified based upon timing and severity of disease. Our understanding of the varied quality of life (QOL) impact in different classifications of rhinitis is limited. Thus a more comprehensive understanding of the impact of rhinitis upon our patients, as measured by both patient reported outcome measures (PROMs) and clinical physiologic measures, as well as unique factors associated with disease severity is needed.
A systematic search of databases was performed to identify AR and NAR studies reporting Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), total nasal symptom score (TNSS), or visual analogue scale (VAS) scores, and physiologic measures including peak nasal inspiratory flow (PNIF) and nasal airflow. Relationships between PROMs, physiologic measures, and associated factors (e.g., allergic status, disease duration) were assessed by weighted correlations and meta-regressions.
A total of 171 studies reporting on 33,843 patients were included. Symptoms were more severe in AR than NAR on VAS (p < 0.001). Classification based upon Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines demonstrated differences in PROM severity. There was no significant correlation between PROMs and demographic factors, comorbidities, or physiologic measures. Meta-regression identified a correlation between worse RQLQ scores and shorter disease duration (r = -0.4, p < 0.001).
Rhinitic patients have more severe impact upon QOL in the presence of allergy with variable impact upon specific symptom subdomains. PROMs do not correlate with common demographic factors, comorbidities, or physiologic measures of nasal airflow.
鼻科医生经常会遇到各种变应性鼻炎 (AR) 和非变应性鼻炎 (NAR) 患者，他们可以根据疾病的发病时间和严重程度进行不同的分类。我们对不同分类的鼻炎对生活质量 (QOL) 影响的了解有限。因此，需要更全面地了解鼻炎对患者的影响，包括患者报告的结果测量 (PROM) 和临床生理测量，以及与疾病严重程度相关的独特因素。
系统地检索数据库，以确定报告 Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ)、总鼻症状评分 (TNSS) 或视觉模拟评分 (VAS) 以及生理测量值（包括峰值鼻吸气流量 (PNIF) 和鼻气流）的 AR 和 NAR 研究。通过加权相关性和荟萃回归评估 PROM、生理测量值和相关因素（例如过敏状态、疾病持续时间）之间的关系。
共纳入了 171 项研究，涉及 33843 名患者。VAS 上 AR 的症状比 NAR 更严重 (p<0.001)。基于过敏性鼻炎及其对哮喘的影响 (ARIA) 指南的分类显示了 PROM 严重程度的差异。PROM 与人口统计学因素、合并症或生理测量值之间没有显著相关性。荟萃回归确定了 RQLQ 评分与疾病持续时间较短之间的相关性 (r=-0.4，p<0.001)。
在存在过敏的情况下，鼻炎患者的生活质量受到更严重的影响，并且对特定症状子领域的影响也不同。PROM 与常见的人口统计学因素、合并症或鼻气流的生理测量值不相关。
