探究广东地区变应性鼻炎合并支气管哮喘的危险因素

doi:10.6040/j.issn.1673-3770.1.2018.038

摘要/Abstract

摘要： 目的回顾性分析确诊为变应性鼻炎(AR)患者的特征及伴发支气管哮喘的危险因素。方法纳入2009年6月至2018年5月在中山大学附属第三医院以及中山大学附属第五医院过敏中心,通过过敏原皮肤点刺试验确诊AR的患者(5~60岁)2 931例,详细采集病史及相关辅助检查结果。利用SPSS 20.0分析不同患者的特征、合并支气管哮喘的风险因素及对应变应原的类型。结果 2 931例患者中,AR合并哮喘207例(7.06%)。多因素逻辑回归显示,AR伴发哮喘的危险因素分别为变应性鼻炎持续时间大于5年、吸烟、自行使用抗生素治疗、哮喘家族史、AR家族史和城市居住环境等。过敏原敏感性分析发现:AR患者最常见的过敏原是屋尘螨,共2 754例(93.96%)。结论广东地区变应性鼻炎患者合并哮喘发生率较低,应针对危险因素进行有效的防治。

关键词: 变应性鼻炎, 支气管哮喘, 过敏原, 逻辑回归分析

Abstract: Objective A retrospective survey was performed on patients who were diagnosed with allergic rhinitis(AR)and its complication, bronchial asthma(BA). The characteristics and allergens in these patients with AR and BA were analyzed to determine the risk factors. Methods The medical records of 2 931 patients with AR(5-60 years old)who had undergone allergen skin puncture tests between June 2009 and May 2018, from two medical centers in Guangzhou and Zhuhai City(The Third and Fifth Affiliated Hospital of Sun Yat-sen University), were analyzed for patient characteristics, risk factors of BA, and allergen types using SPSS 20.0. Results Among the 2 931 patients, 207(7.06%)had AR with BA. The strongest risk factor for BA, as determined by a multiple logistic regression analysis, was AR for a duration of 5 years; this was followed by smoking, self-medication with antibiotics, a family history of AR and BA, and urban living. The most common sensitization was to house-dust mites(93.96%). Conclusion Our findings suggest that the risk factors for concomitant BA in patients with AR may be helpful in establishing preventive strategies.

Key words: Allergic rhinitis, Bronchial asthma, Allergen, Logistics regression

中图分类号:

R765.21

洪海裕, 许光福, 杨烁伟,苏荣飞,黄伊厘,池梦诗,王玮豪,杨钦泰. 探究广东地区变应性鼻炎合并支气管哮喘的危险因素[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 94-98.

HONG Haiyu, XU Guangfu, YANG Shuowei, SU Rongfei, HUANG Yili, CHI Mengshi,WANG Weihao,YANG Qintai. The prevalence and risk factors of bronchial asthma in patients with allergic rhinitis in Guangdong Province[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 94-98.

参考文献 23

[1]	To T, Stanojevic S, Moores G, et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey[J]. BMC Public Health, 2012, 12: 204. doi:10.1186/1471-2458-12-204.
[2]	Mullol J, Valero A, Alobid I, et al. Allergic Rhinitis and its Impact on Asthma update(ARIA 2008). The perspective from Spain[J]. J Investig Allergol Clin Immunol, 2008, 18(5):327-334.
[3]	Shaaban R, Zureik M, Soussan D, et al. Rhinitis and onset of asthma:a longitudinal population-based study[J]. Lancet, 2008, 372(9643):1049-1057. doi:10.1016/S0140-6736(08)61446-4.
[4]	Guerra S, Sherrill DL, Martinez FD, et al. Rhinitis as an independent risk factor for adult-onset asthma[J]. J Allergy Clin Immunol, 2002, 109(3):419-425.
[5]	中华医学会耳鼻咽喉头颈外科学分会鼻科学组,中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016(1):6-24.
[6]	中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案)[J]. 中华结核和呼吸杂志, 2008,31(3):177-185.
[7]	Bro ek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma(ARIA)guidelines-2016 revision[J]. J Allergy Clin Immunol, 2017, 140(4):950-958. doi:10.1016/j.jaci.2017.03.050.
[8]	Wheatley LM, Togias A. Clinical practice. allergic rhinitis[J]. N Engl J Med, 2015, 372(5):456-463. doi:10.1056/NEJMcp1412282.
[9]	Shaaban R, Zureik M, Soussan D, et al. Rhinitis and onset of asthma: a longitudinal population-based study[J]. Lancet, 2008, 372(9643):1049-1057. doi:10.1016/S0140-6736(08)61446-4.
[10]	Asher MI, Keil U, Anderson HR, et al. International Study of Asthma and Allergies in Childhood(ISAAC):rationale and methods[J]. Eur Respir J, 1995, 8(3):483-491.
[11]	Spergel JM. From atopic dermatitis to asthma:the atopic march[J]. Ann Allergy Asthma Immunol, 2010, 105(2):99-106; quiz 107-9, 117. doi:10.1016/j.anai.2009.10.002.
[12]	Ozdoganoglu T, Songu M. The burden of allergic rhinitis and asthma[J]. Ther Adv Respir Dis, 2012, 6(1):11-23. doi:10.1177/1753465811431975.
[13]	马思远, 娄鸿飞, 王成硕, 等. 北京地区可疑过敏性鼻炎病人吸入性变应原特征分析[J]. 首都医科大学学报, 2017, 38(5):671-676. doi:10.3969/j.issn.1006-7795.2017.05.009. MA Siyuan, LOU Hongfei, WANG Chengshuo, et al. Characteristic analysis of aeroallergens in Beijing patients suspicious of allergic rhinitis[J]. Journal of Capital Medical University, 2017, 38(5):671-676. doi:10.3969/j.issn.1006-7795.2017.05.009.
[14]	Owens L, Laing IA, Zhang GC, et al. Prevalence of allergic sensitization, hay fever, eczema, and asthma in a longitudinal birth cohort[J]. J Asthma Allergy, 2018, 11:173-180. doi:10.2147/JAA.S170285.
[15]	Pajno GB, Bernardini R, Peroni D, et al. Clinical practice recommendations for allergen-specific immunotherapy in children:the Italian consensus report[J]. Ital J Pediatr, 2017, 43(1):13. doi:10.1186/s13052-016-0315-y.
[16]	Jutel M, Agache I, Bonini S, et al. International consensus on allergy immunotherapy[J]. J Allergy Clin Immunol, 2015, 136(3):556-568. doi:10.1016/j.jaci.2015.04.047.
[17]	Saxon A, Diaz-Sanchez D. Air pollution and allergy:you are what you breathe[J]. Nat Immunol, 2005, 6(3):223-226. doi:10.1038/ni0305-223.
[18]	程雷, 钱俊俊, 田慧琴. 变应性鼻炎研究的若干进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(3):1-3. doi:10.6040/j.issn.1673-3770.1.2017.021. CHENG Lei, QIAN Junjun, TIAN Huiqin. Research progresses on allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(3):1-3. doi:10.6040/j.issn.1673-3770.1.2017.021.
[19]	赵延明, 张罗. 过敏性鼻炎的遗传学研究进展[J]. 首都医科大学学报, 2013, 34(6):808-813. doi:10.3969/j.issn.1006-7795.2013.06.006. ZHAO Yanming, ZHANG Luo. Progress in genetic study on allergic rhinitis[J]. Journal of Capital Medical University, 2013, 34(6):808-813. doi:10.3969/j.issn.1006-7795.2013.06.006.
[20]	梁峥琰, 邓玉琴, 陶泽璋. 母亲过敏和环境暴露对免疫成熟的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(3):96-104. LIANG Zhengyan, DENG Yuqin, TAO Zezhang. Effect of maternal allergy and environmental exposure on immune maturation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(3):96-104.
[21]	Alm B, Goksör E, Pettersson R, et al. Antibiotics in the first week of life is a risk factor for allergic rhinitis at school age[J]. Pediatr Allergy Immunol, 2014, 25(5):468-472. doi:10.1111/pai.12244.
[22]	Hong HY, Yang QT, Zuo KJ, et al. A hospital-based survey on the prevalence of bronchial asthma in patients with allergic rhinitis in southern China[J]. Am J Rhinol Allergy, 2013, 27(6):502-505. doi:10.2500/ajra.2013.27.3951.
[23]	娄鸿飞, 马思远, 赵岩, 等. 京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析[J]. 首都医科大学学报, 2017, 38(5):665-670. doi:10.3969/j.issn.1006-7795.2017.05.008. LOU Hongfei, MA Siyuan, ZHAO Yan, et al. Sensitization patterns for aeroallergens in self-reported allergic rhinitis within Beijing, Tianjin, and Hebei region[J]. Journal of Capital Medical University, 2017, 38(5):665-670. doi:10.3969/j.issn.1006-7795.2017.05.008.

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