夏秋季花粉症患者合并变应性鼻炎和变应性哮喘情况及其相互关系的研究

The clinical study of the relationship between allergic rhinitis and allergic asthma in the patients with autumnal pollinosis

目的探讨夏秋季花粉症患者中变应性鼻炎和变应性哮喘的关系。方法对2001年8月至2003年12月确诊为夏秋季花粉症的1120例患者进行吸入变应原皮内试验和血清特异性IgE检测(法玛西亚公司UinCAP100荧光酶联免疫法),同时对变应性鼻炎和变应性哮喘患者的发病年龄、发病时间、临床症状特点及哮喘的严重程度进行标准临床问卷调查和研究。结果夏秋季花粉诱发的变应性鼻炎的平均发病年龄27.9岁,变应性哮喘的平均发病年龄32.6岁,两者差异有统计学意义(P<0.001);在全部夏秋花粉症患者中,变应性鼻炎占97.9%(1096/1120),单纯变应性鼻炎占45.6%(511/1120);变应性哮喘占53.8%(602/1120),单纯变应性哮喘占0.9%(10/1120)。在变应性鼻炎患者中53.4%(585/1096)合并季节性变应性哮喘;在季节性变应性哮喘患者中97.2%(585/602)合并变应性鼻炎,30.8%(183/602)需要急诊治疗。结论变应性鼻炎合并哮喘的状况在夏秋季花粉症患者中不容忽视,夏秋季花粉是中国北方地区夏秋季哮喘的重要原因。

Objective To investigate the relationship between allergic rhinitis and allergic asthma in the patients with autumnal pollinosis. Methods 1120 patients with autumnal pollinosis, aged 5～75, excluding those with typical symptoms of seasonal rhinitis or asthma but with positive skin test and serum IgE specific to dustmite and fungi, underwent standardized clinical questionnaire survey, including the onset age, onset time, and symptoms as well as the severity of asthma, skin tests, and examination of serum IgE specific to autumnal pollens. Results The average onset age of the allergic rhinitis patients induced by autumnal pollens was 27.9 years, significantly younger than that of the allergic asthma patients (32.6 years, P<0.001). Out of the 1120 patients 1096 (97.9 %) had allergic rhinitis, 602 (53.8 %) had asthma, 507 (45.3%) had allergic rhinitis only, and 10 (0.9%) had allergic asthma only. Among the 1096 patients with allergic rhinitis 585 (53.4%) suffered from seasonal asthma. Among the 602 patients with asthma 585 (97.2%) suffered from seasonal rhinitis, and 183 of the 602 patients (30.8 %) needed emergency treatment. Conclusion Autumnal pollens are very important causes which induce asthma during autumnal season in northern China.