鼻声反射和鼻阻力检查在气道炎症应用中的评价

Application of acoustic rhinometry and nasal airway resistance examination in study of airway inflammation

目的探讨在上下气道炎症研究中鼻声反射、鼻阻力检查的参数选择及临床应用价值。方法应用鼻声反射仪及鼻阻力计对变应性鼻炎、哮喘患者及正常人鼻激发试验前后鼻腔通气功能进行测量,比较两种检查方法的差异,分析上下气道炎症的关系。结果与正常对照组比较,鼻激发试验前后变应性鼻炎组、哮喘组鼻腔容积(nasal volume,NV)变化有显著性差异(P<0.05),鼻腔阻力(nasal airway resistance,NAR)变化也有显著性差异(P<0.05)。②变应性鼻炎组、哮喘组NV与NAR变化率均呈负相关(r鼻炎=-0.673;r哮喘=-0.497,P<0.01),但NAR变异系数(coefficient of variation,CV)较大。正常组NV与NAR变化率无明显相关(r正常组=0.120,P>0.05)。③以鼻声反射NV减少20%或NAR增加20%作为阳性标准,变应性鼻炎组、哮喘组与正常对照组NV阳性率的差异有统计学意义(χ2=23.03,P<0.01),NAR阳性率差异也有统计学意义(χ2=28.06,P<0.01)。结论AR、NAR检查均可作为评价鼻激发试验(nasal provocation testing,NPT)前后鼻腔通气功能的客观检查,但是,AR比NAR检查更为简便、迅速,精确度更高,重复性更好。②上、下气道炎症存在密切相关性。

Objective To evaluate the application of acoustic rhinometry and nasal airway resistance exam/nation in the study of airway inflammation. Methods The nasal ventilation function was detected with acoustic rhinometry and nasal airway resistance examination before and after nasal provocation testing （ NPT ） . The difference between these two detection methods was compared and the relationship between inflammation of upper and lower airways was also analyzed. Results ① Compared with the change rates of nasal volume （ NV ） and nasal airway resistance （ NAR ） before and after NPT in normal control group , the differences of those between the allergic rhinitis group and the asthma group were statistically significant （ FNy = 7. 220 , PNv 〈 0. 05 ; FNANAR = 7. 590 , PKAR 〈 0. 05 ） . ② In both allergie rhinitis group and asthma group, the change rate of NV was inversely correlated with that ofNAR （ rallergic rhinitis group = - 0 . 673 , P 〈 0 . 01 ; rasthma group= - 0. 497 , P 〈 0. 01 ） , but the variation coefficient of the change rate of NV was greater than that of NAR. The changerate of NV was not correlated with that of NAR in the normal control group （ r normal coutrol group=0 . 1 2 0 , P 〉 0. 05 ） . ③ Taking NV reduction or NAR increase greater than 20% as the positive criteria of NPT, the differences of NV positive rates or NAR positive rates between the allergic rhinitis group and the nounal control group were statistically significant （ P 〈 0. 01 ） , and those between the asthma group and the normal control group were also statistically significant （ P 〈 0. 01 ）. Conclusion ① Both AR and NAR examination are suitable for objective evaluation of nasal ventilation function in NPT. Due to its simplicity, rapidity, high accuracy and good duplication, AR is preferable to NAR examination. ②The inflammation of upper and lower airway is closely related.