主动吸烟过敏性鼻炎患者鼻部症状的特征分析

Characteristics of Active Cigarette Smoking on Adult Allergic Rhinitis Patients

目的评价主动吸烟的过敏性鼻炎(allergic rhinitis,AR)患者鼻腔局部症状的严重程度。方法收集2010年2月~2020年2月于武汉大学人民医院和首都医科大学附属北京朝阳医院门诊就诊的641例AR患者资料,回顾性分析患者的基本信息(性别、年龄、受教育程度、过敏症家族史)、吸烟状况(日吸烟量、吸烟持续时间、戒烟时间)和鼻部症状视觉模拟量表(visual analogue scale,VAS)评分,分析症状评分与吸烟量之间的相关性。结果将患者分为A组(每天主动吸烟>1支且至少持续1年及以上,65例)、B组(曾经每天主动吸烟>1支且至少持续1年及以上,目前已戒烟且戒烟持续时间达1年及以上,16例)和C组(包括被动吸烟在内的吸烟史,560例)。AR患者主动吸烟率为14.5%,吸烟组患者以男性为主(A组和B组中男性分别占93.8%和100%)。B组患者的吸烟量(16.1±7.2支/日)显著高于A组患者(12.3±6.7支/日)。B组与A组患者的吸烟持续时间比较,差异无统计学意义,但在≥35岁年龄组中,B组患者的吸烟持续时间显著长于A组(28.2±10.8年vs 19.3±9.8年)。鼻部症状VAS评分结果显示,A组较C组AR患者的流涕评分(6.7±3.3分vs 5.6±2.7分)和鼻痒评分(5.7±3.5分vs 4.6±2.7分)显著增高;B组较C组AR患者的鼻痒评分(6.4±1.9分vs 4.6±2.7分)和症状总分(5.9±1.3分vs 5.1±1.8分)显著增高。但A组AR患者鼻塞评分显著低于C组(4.0±3.2分vs 5.0±2.8分)。A组AR患者与B组AR患者在各症状维度上比较,差异均无统计学意义。相关性分析显示,A组AR患者流涕评分与吸烟量显著相关(r=0.318);在所有吸烟患者中,<35岁患者的鼻塞、喷嚏、流涕和鼻部症状总分与吸烟量显著相关(r分别为0.353、0.400、0.395、0.442)。结论主动吸烟AR患者的总体鼻部症状更为严重,且严重程度随吸烟量而增加。其中,流涕症状评分与吸烟量呈显著正相关。

Objective To evaluate the nasal symptoms in current cigarette smokers,ex-cigarette smokers and non-smokers with AR.Methods We conducted a retrospective study in AR patients at Wuhan University and Beijing Chaoyang Hospital,Capital Medical University from February 2010 to February 2020,641 AR patients were enrolled in this study.Basic information,smoking status,and Visual Analogue Scale(VAS)scores of nasal symptoms were collected to identify factors related to nasal symptoms.Results AR patients meeting the diagnostic criteria were divided into three groups as A group(smoking>1 cigarette per day for at least 1 year,65 patients),B group(previously smoking>1 cigarette per day for at least 1 year and stopped smoking for more than 1 year,16 patients)and C group(no smoking history including chronic secondary smoking exposure,560 patients).14.5%of patients with AR were active smokers.The smoking groups were predominantly male(male patients in the current smoking group and previous smoking group accounted for 93.8%and 100%respectively).The daily cigarette consumption of patients in the ex-smoking group(16.1±7.2 cigarettes/day)was significantly higher than that of patients in the current smoking group(12.3±6.7 cigarettes/day).There was no significant difference in the duration of smoking between the ex-smoking group and the current smoking group.However,in the high-age group(≥35 years),the smoking duration of the ex-smoking group was significantly longer than that of the current smoking group(28.2±10.8 years vs 19.3±9.8 years).The rhinorrhea score(6.7±3.3 points vs 5.6±2.7 points)and itching score(5.7±3.5 points vs 4.6±2.7 points)of AR patients in the current smoking group were significantly higher than those of AR patients in the non-smoking group.The itching score(6.4±1.9 points vs 4.6±2.7 points)and total symptom score(5.9±1.3 points vs 5.1±1.8 points)in the ex-smoking group of AR patients were significantly higher than those of AR patients in the non-smoking group.In contrast,the nasal congestion score in the current smoking group were significantly lower than of AR patients in the non-smoking group(4.0±3.2 points vs 5.0±2.8 points).There was no significant difference between AR patients in the current smoking group and in the ex-smoking group in all symptom dimensions.Correlation analysis showed that the rhinorrhea score was significantly correlated with the daily cigarette consumption in the current smoking group(r=0.318).A subgroup analysis among all smoking patients found that the nasal congestion score,sneeze score,rhinorrhea score and total score of nasal symptoms in patients younger than 35 years old was significantly correlated with daily cigarette consumption(r were 0.353,0.400,0.395,0.442).Conclusion The overall nasal symptoms of patients with active smoking AR are more severe,and the severity increases with the amount of smoking.Among them,the runny nose symptom score was significantly positively correlated with the amount of smoking.