变应性鼻炎对哮喘患者临床控制及肺通气功能的影响

Allergic rhinitis and its impact on asthma control and pulmonary function

目的探讨变应性鼻炎对支气管哮喘(简称哮喘)患者临床控制及肺通气功能的影响。方法收集2010年5月—2011年7月解放军总医院呼吸科及耳鼻咽喉头颈外科门诊就诊的63例哮喘和哮喘合并变应性鼻炎患者,将其分为2组,支气管哮喘组(哮喘组)32例,哮喘合并变应性鼻炎组(哮喘并鼻炎组)31例。比较2组间哮喘控制测试(ACT)评分、哮喘控制问卷(ACQ)评分、最近1个月使用沙丁胺醇气雾剂次数、第1秒呼气容积占预计值百分比(FEV_1%)和呼气峰流量占预计值百分比(PEF%)。结果 ACT评分在哮喘组为(19.0±4.7)分,在哮喘并鼻炎组为(16.3±5.6)分;ACQ评分在哮喘组为(1.4±1.1)分,在哮喘并鼻炎组为(2.1±1.3)分;最近1个月使用沙丁胺醇气雾剂次数在哮喘组为0(0,5)次,在哮喘并鼻炎组为4(0,12)次;FEV_1%在哮喘组为(77,7±21.7)%,在哮喘并鼻炎组为(64.7±23.1)%;PEF%在哮喘组为(79.4±26.3)%,在哮喘并鼻炎组为(65.8±22.0)%。与哮喘组比较,哮喘并鼻炎组的AC3评分、FEV_1%和PEF%明显降低(P<0.05),ACQ评分、最近1个月使用沙丁胺醇气雾剂次数明显升高(P<0.05)。结论合并变应性鼻炎不利于哮喘患者的临床控制,可增加哮喘症状及急救用药次数并使其肺通气功能下降。

Objective To determine the impact of allergic rhinitis on asthma clinical control and lung function. Methods Sixty-three patients with asthma alone or patients with asthma combined with allergic rhinitis(36 males and 27 females, mean age;48.6±16.1 years) were divided into asthma group(n=32)and asthma combined with allergic rhinitis (AR) group(n=31) at Chinese PLA general hospital.The Asthma Control Test(ACT)score,the Asthma Control Questionnaire (ACQ) score,rescue use of salbutamol agonist and percent predicted FEV_1(FEV_1%),percent predicted PEF (PEF%) were evaluated respectively between asthma alone group and asthma combined with AR group.Results The patients in asthma combined with AR group had a significantly(P<0.05) lower ACT score(16.3±5.6)than those with asthma alone(19.0±4.7);whereas the ACQ score(2.1±1.3) in patients with asthma combined with AR was significantly higher than those(1.4±1.1) with asthma alone(P<0.05).The need for the salbutamol-agonist as a rescue medication 4 (0,12) in patients with asthma combined with AR was significantly(P<0.05) higher than those 0(0,5) with asthma alone. The FEV_1%(64.7±23.1)%in patients with asthma combined with AR was significantly(P<0.05)lower than those (77.7±21.7)%with asthma alone,and the PEF%(65.8±22.0)%in the patients with asthma combined with AR was significantly(P<0.05) lower than those(79.4±26.3)%with asthma alone.Conclusion The patients with asthma combined with AR experienced more poor clinical control and severe asthmatic symptoms,and more need for salbutamol agonist as a rescue medication,and decreased in pulmonary function.