Al-Hadrawi Zainab, Giezeman Maaike, Hasselgren Mikael, Janson Christer, Kisiel Marta A, Lisspers Karin, Montgomery Scott, Nager Anna, Sandelowsky Hanna, Ställberg Björn, Sundh Josefin
Department of Respiratory Medicine, Örebro University Hospital, Örebro, Sweden.
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Eur Clin Respir J. 2024 Aug 30;11(1):2397174. doi: 10.1080/20018525.2024.2397174. eCollection 2024.
The study aimed to compare prevalence of comorbid allergic manifestations and rhinitis, allergy testing and associations with patient-related outcomes in patients with asthma and COPD.
Cross-sectional study of randomly selected Swedish patients with a doctor's diagnosis of asthma ( = 1291) or COPD ( = 1329). Self-completion questionnaires from 2014 provided data on demographics, rhinitis, allergic symptoms at exposure to pollen or furry pets, exacerbations, self-assessed severity of disease and scores from the Asthma Control Test (ACT) and the COPD Assessment Test (CAT), and records were reviewed for allergy tests.
Allergic manifestations were more common in asthma (75%) compared with COPD (38%). Rhinitis was reported in 70% of asthma and 58% of COPD patients. Allergy tests had been performed during the previous decade in 28% of patients with asthma and in 8% of patients with COPD.In patients with asthma; comorbid allergy and rhinitis were both independently associated with increased risk for poor asthma symptom control (ACT < 20) (OR [95% CI] 1.41 [1.05 to 1.87] and 2.13 [1.60 to 2.83]), exacerbations (1.58 [1.15 to 2.17] and 1.38 [1.02 to 1.86]), and self-assessed moderate/severe disease (1.64 [1.22 to 2.18] and 1.75 [1.33 to 2.30]). In patients with COPD, comorbid allergy and rhinitis were both independently associated with increased risk for low health status (CAT ≥ 10) (OR [95% CI] 1.46 [1.20 to 1.95] and 2.59 [1.97 to 3.41]) respectively, with exacerbations during the previous six months (1.91 [1.49 to 2.45] and 1.57 [1.23 to 2.01]), and with self-assessed moderate/severe disease (1.70 [1.31 to 2.22] and 2.13 [1.66 to 2.74]).
Allergic manifestations and rhinitis are more common in asthma than COPD but associated with worse outcomes in both diseases. This highlights the importance of examining and treating comorbid allergy and rhinitis, not only in asthma but also in COPD.
本研究旨在比较哮喘和慢性阻塞性肺疾病（COPD）患者中合并过敏表现和鼻炎的患病率、过敏检测情况以及与患者相关结局的关联。
对随机选取的、经医生诊断为哮喘（n = 1291）或COPD（n = 1329）的瑞典患者进行横断面研究。2014年的自填问卷提供了人口统计学数据、鼻炎、接触花粉或带毛宠物时的过敏症状、病情加重情况、自我评估的疾病严重程度以及哮喘控制测试（ACT）和慢性阻塞性肺疾病评估测试（CAT）的评分，并查阅记录以获取过敏检测情况。
与COPD（38%）相比，过敏表现在哮喘患者中更为常见（75%）。70%的哮喘患者和58%的COPD患者报告有鼻炎。在过去十年中，28%的哮喘患者和8%的COPD患者进行过过敏检测。在哮喘患者中，合并过敏和鼻炎均与哮喘症状控制不佳（ACT < 20）风险增加独立相关（比值比[95%置信区间]为1.41[1.05至1.87]和2.13[1.60至2.83]）、病情加重（1.58[1.15至2.17]和1.38[1.02至1.86]）以及自我评估为中度/重度疾病（1.64[1.22至2.18]和1.75[1.33至2.30]）。在COPD患者中，合并过敏和鼻炎分别与健康状况不佳（CAT≥10）风险增加独立相关（比值比[95%置信区间]为1.46[1.20至1.95]和2.59[1.97至3.41]）、过去六个月内病情加重（1.91[1.49至2.45]和1.57[1.23至2.01]）以及自我评估为中度/重度疾病（1.70[1.31至2.22]和2.13[1.66至2.74]）。
过敏表现和鼻炎在哮喘患者中比在COPD患者中更常见，但在两种疾病中均与更差的结局相关。这凸显了不仅在哮喘中而且在COPD中检查和治疗合并过敏和鼻炎的重要性。
