山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (6): 48-52.doi: 10.6040/j.issn.1673-3770.0.2013.165

• 论著 • 上一篇    下一篇

不同程度持续性变应性鼻炎对下气道的影响

张恺1,王秋萍1,吴昆旻1,王志颐1,张勇1,季俊峰1,程友1,谢燕清2,钟南山2   

  1. 1.南京大学医学院临床学院 南京军区南京总医院耳鼻咽喉-头颈外科, 南京 210002;
    2.广州医学院第一附属医院呼吸疾病研究所, 广州 510120
  • 收稿日期:2013-06-05 发布日期:2013-12-16
  • 通讯作者: 王秋萍,教授。 Email:qpwang1016@vip.sina.com
  • 作者简介:张恺。 Email:zhangkainju@sina.com
  • 基金资助:

    呼吸疾病国家重点实验室开放课题(2007DA780154F0907)

Impact of persistent allergic rhinitis of different degrees on the lower airway

ZHANG Kai1, WANG Qiu-ping1, WU Kun-min1, WANG Zhi-yi1, ZHANG Yong1, JI Jun-feng1, CHENG You1, XIE Yan-qing2, ZHONG Nan-shan2   

  1. 1. Department of Otolaryngology and Head & Neck Surgery, School of Medicine, Nanjing University/Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing 210002, China; 2. Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China
  • Received:2013-06-05 Published:2013-12-16

摘要:

目的    检测下气道炎症相关指标,探讨不同程度持续性变应性鼻炎(perennial allergic rhinitis,PAR)对下气道影响的程度及差异。方法    入选PAR患者266例,其中轻度组(165例)、中-重度组(101例),另选健康正常组136例,均行诱导痰嗜酸性粒细胞(eosinophils,EOS)计数、呼出气一氧化氮(fraction of exhaled nitric oxide,FeNO)检测及支气管激发试验(bronchial provocation test,BPT),比较三组受试者对下气道影响的程度和差异。结果    ①三组间FeNO及FeNO阳性率的差异均具有统计学意义(39.07±24.29 vs 25.81±18.68 vs 9.01±10.01,P<0.01;66.19% vs 33.33% vs 8.82%,P<0.01);②两组鼻炎患者痰EOS比例及痰EOS阳性率的差异无统计学意义(5.51±9.11% vs 4.02±7.10%;40.59% vs 35.57%,P>0.05),与正常组的差异均有统计学意义(5.51±9.11% vs 0.48±1.28%, 4.02±7.10% vs 0.48±1.28%;40.59% vs 1.47%,35.57% vs 1.47%,P<0.01);③中-重度组BPT阳性率与轻度组、正常组差异均有统计学意义(14.85% vs 4.24%,14.85% vs 1.23%,P<0.01 ),轻度组与正常组差异无统计学意义(4.24% vs 1.23%,P>0.05)。结论    ①不同程度PAR患者下气道炎症存在差异;②研究证实,中-重度PAR患者呈现出更高水平的下气道异常,针对此类患者,可能暗示未来罹患哮喘(BA)的风险,耳鼻喉及呼吸科临床医师应给予高度重视。

关键词: 气道炎症, 持续性变应性鼻炎, 气道高反应性, 诱导痰, 呼出气一氧化氮

Abstract:

Objective    To determine the characters and difference of the impact of persistent allergic rhinitis of different degrees on the lower airway. Methods    All patients enrolled in this study were categorized into three groups, the mild group(165 subjects), the moderate/severe group(101 subjects), and the normal control group(136 healthy subjects). Induced sputum differential cytology tests, measurements of exhaled nitric oxide concentration and methacholine bronchial provocation tests were performed. The character and difference in the lower airway among the three groups were compared. Results        ① The measurements of fractional exhaled nitric oxide concentration and the positive rate of fractional exhaled nitric oxide concentration of the moderate/severe group and the mild group both had significant statistical difference with the normal control group(39.07±24.29 vs 25.81±18.68 vs 9.01±10.01, P<0.01; 66.19% vs 33.33% vs 8.82%, P<0.01) ; ② Proportion and positive rate of eosinophils in induced sputum of the two rhinitis groups had no significantly statistical difference with each other(5.51±9.11% vs 4.02±7.10%; 40.59% vs 35.57%, P>0.05), but they both had significantly statistical difference with the normal control group(5.51±9.11% vs  0.48±1.28%, 4.02±7.10% vs 0.48±1.28%; 40.59% vs 1.47%, 35.57% vs 1.47%, P<0.01); ③ Positive rate of bronchial provocation test of the moderate/severe group had significantly statistical difference with the mild group and the normal control group(14.85% vs 4.24%,14.85% vs 1.23%, P<0.01), but the mild group had no significantly statistical difference with the normal control group(4.24% vs 1.23%, P>0.05). Conclusion    ① The disparity of the lower airway inflammation consists in perennial allergic rhinitis of different degrees; ② Our research demonstrates that the moderate/severe perennial allergic rhinitis exhibits superior lower airway abnormality, indicating that such patients have high-risk of suffering from asthma, in view of this condition, they should be paid sufficient attention to by otorhinolaryngologists and respiratory physicians.

Key words: Bronchial hyperresponsiveness, Fractional exhaled nitric oxide, Airway inflammation, Perennial allergic rhinitis, Induced sputum

中图分类号: 

  • R765.21
[1] 张田1,陈剑秋1,林家峰1,李跟红1,叶犇1,贺祯1,赵秀娟1,王慧丽2,朱春生1. 鼻内镜下手术治疗变应性鼻炎伴鼻中隔偏曲疗效观察[J]. 山东大学耳鼻喉眼学报, 2013, 27(3): 27-29.
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