变应性鼻炎和非变应性鼻炎炎症特征比较研究

Inflammatory characteristics of nonallergic rhinitis and allergic rhinitis

目的探讨变应性鼻炎(allergic rhinitis,AR)和非变应性鼻炎(nonallergic rhinitis,NAR)炎症特征的差异。方法 2010年6月～2011年6月初次在我院耳鼻咽喉科就诊的AR患者101例、NAR患者117例及健康对照组162例,检验血液、鼻灌洗、诱导痰中EOS计数,并应用鼻激发和支气管激发试验等炎症相关的指标评价和分析AR和NAR的炎性特征的差异。结果 AR组鼻灌洗EOS计数、血清EOS比例、诱导痰EOS比例均显著高于NAR组(P<0.0 5)和对照组(P<0.0 5);而NAR组鼻灌洗EOS计数、血清EOS比例、诱导痰EOS比例也显著高于对照组(P<0.0 5)。AR组鼻激发阳性率为7 5.2%,高于NAR组(6 5.8%),但两者比较差异无统计学意义(χ2=2.3 1,P>0.0 5);而AR组、NAR组与对照组(32.1%)比较,差异具有统计学意义(χ2分别为46.36、31.06,P<0.01)。AR组支气管激发阳性率为14.9%,高于NAR组(10.3%),但两者比较差异无统计学意义(χ2=1.0 6,P>0.0 5);而AR组、NAR组与对照组比较,差异具有统计学意义(χ2分别为19.08、11.60,P<0.01)。结论AR和NAR患者鼻、下气道和全身均存在EOS炎症和气道高反应性,但AR组高于NAR组。临床中在关注AR患者与NAR患者的上气道炎症状况的同时,应重视下气道及全身炎症状况。

Objective To describe the differences of inflammatory characteristics between allergic rhinitis （AR） and nonallergic rhinitis （NAR）. Methods The differences of inflammatory characteristics between AR and NAR were assessed by using disease survey, skin prick test （SPT） , visual analogue scale （VAS） , eosinophil count of nasal douche, serum and induced sputum, nasal and bronchial provocation test separately. 101 AR patients, 117 NAR patients and 162 normal controls were included in this study. Results The eosinophils in nasal douche, induced sputum and serum of AR group were significantly higher than those of other two groups （ P 〈 0.05 ）. At the same time, the eosinophils in nasal douche, induced sputum and serum of NAR group were significantly higher than those of the control group （ P 〈 0.05 ）. Positive rate of nasal provocation test of AR group was 75.2% , which was higher than that of the NAR group （65.8%） without significant difference （ P 〉 0.05 ）. But the positive rates of the AR and NAR groups were both significantly higher than that of the control group （ P 〈 0.01 ）. The positive rate of bronchial provocation test of AR group （ 14.9 % ） was higher than that of the NAR group （ 10.3 % ）, but the difference was statistically insignificant （ P 〉 0.05 ）. The positive rates of bronchial provocation test of AR and NAR group were also significantly higher than control group respectively （ P 〈 0.01 ）. Conclusion Nasal, lower airwayand systemic eosinophilic inflammation and airway hyperresponsiveness exist in AR and NAR patients. The inflammation and hyperresponsiveness of AR was more serious than that of NAR. In clinical practice, we should concern about not only the nasal inflammation but also the status of the lower airway and systemic inflammation in patients with AR and NAR.