不伴哮喘的鼻炎患者肺小气道功能的改变

Changes in small airway function in rhinitis without asthma

目的:观察不伴哮喘的鼻炎患者的肺小气道功能改变情况。方法:2008-06-2012-12期间共纳入研究对象903例,分为3组,其中变应性鼻炎(AR)组377例,非变应性鼻炎(NAR)组262例,健康对照组264例。全部研究对象均行病史采集、鼻部专科检查、变应原皮肤点刺试验、肺通气功能检查、支气管激发试验。结果:AR组FEV1/FVC%、MMEF pred%以及MEF 25pred%指标均显著低于健康对照组(P<0.05);NAR组FEV1/FVC、MMEF pred%、MEF 25pred%以及MEF 50pred%指标均显著低于健康对照组(P<0.05),而FVC pred%、FEV 1pred%指标与健康对照组比较差异无统计学意义(P>0.05)。AR组与NAR组之间各肺功能指标均差异无统计学意义(P>0.05)。AR组出现气道高反应性的比例为12.2%,NAR组为6.1%,其中气道高反应性组的小气道功能指标均显著低于无气道高反应性组(P<0.05)。结论:与健康对照组比较,鼻炎患者出现明显小气道功能的改变,部分鼻炎患者有气道高反应性,且与小气道功能改变相关。

Objective：Observe the changes of small airway function in patients with rhinitis but without asthma and/or lower airway symptoms. Method ： Between June 2008 and December 2012, we recruited 903 subjects, including 377 with allergic rhinitis（AR）, 262 with non-allergic rhinitis（NAR） and 264 healthy subjects. All subjects underwent meticulous history taking, nasal examination, allergen skin prick test, blood routine test, serum total immunoglobin E assay, pulmonary ventilation function test and bronchial challenge test. Result：The indices of FEV1/FVC% , MEF25pred% and MMEFpred% were lower in AR group than in tile control group（P〈0.05）. The indices of FEV1/FVC, MMEFpred% , MEF25pred% and MEF50pred% were also lower in NAR group than in the control group（P〈0.05）. According to the FVCpred% and FEVlpredY00, there were no differences between rhinitis group and the control group （P〉 0.05）. The positive rate of airway hyperresponsiveness （AHR） in AR group and in NAR group was 12.2%, 6.1% respectively. Indices of small airway function were all lower in the AHR group than NAHR group in rhinitis. Conclusion： Compared with healthy controls, small airway function in patients with rhinitis has apparent changes, part of rhinitis patients has AHR, and is associated with small airway function changes.