Persistent Allergic Rhinitis Has a Moderate Impact on the Sense of Smell, Depending on both Nasal Congestion and Inflammation
Persistent Allergic Rhinitis Has a Moderate Impact on the Sense of Smell, Depending on both Nasal Congestion and Inflammation
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DOI：
10.1002/lary.20075
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发表时间：
2009-02-01
期刊：
影响因子：
2.6
通讯作者：
Mullol, Joaquim
中科院分区：
文献类型：
--
作者：
Guilemany, Jose Maria;Garcia-Pinero, Alfons;Mullol, Joaquim
目的/假设：季节性和常年性变应性鼻炎患者存在一定程度的嗅觉障碍，但持续性变应性鼻炎(PER)患者的嗅觉改变尚未得到评估。这项研究的目的是评估PER对嗅觉的影响，并基于自我报告的低分化症(SRH)和PER严重性来表征这种影响。研究设计/方法：对49例PER患者进行前瞻性对照研究。根据严重程度和SRH的存在对PER患者进行细分。用巴塞罗那嗅觉测试-24(BAST-24)嗅觉测定仪评估嗅觉功能。以60名健康志愿者为对照，对第一和第五脑神经(CN)依赖气味进行检测、识别和强制选择。在SRH患者中，用最大吸气流量(PNIF)和鼻声学测量评估鼻塞，用鼻一氧化氮(NNO)评估鼻部炎症。结果：大多数患者(67%)表现为SRH。中度/重度PER(84.8%)在SRH患者中占优势，而轻度PER(75%)在非SRH患者中占主导地位。对于与第一和第五个CN相关的气味，PER患者的嗅觉检测、识别和强制选择测试明显比健康对照组差(P<；0.05)。在亚组中，与健康对照组相比，中度/重度PER和/或SRH患者的嗅觉检测显著减少(P<；0.05)。鼻腔NO(R：0.4；P<；0.05)与嗅觉丧失相关。结论：PER患者有中度嗅觉丧失(BAST-24)，在自我报告的功能低下和中至重度PER患者中损害程度较高。这些结果表明，无论是在临床环境中还是在临床试验中，所有过敏性鼻炎患者的嗅觉都应该得到进一步的研究：
Objectives/Hypothesis: A degree of smell disturbance has been found in seasonal and perennial allergic rhinitis, but alterations in olfaction in patients with persistent allergic rhinitis (PER) have not yet been evaluated. The aims of the study were to evaluate the impact of PER on the sense of smell, and to characterize this impact based on self-reported hyposmia (SRH) and PER severity.Study Design/Methods: A prospective controlled study was performed on 49 consecutive patients with PER. PER patients were subclassified depending on severity and the presence of SRH. Olfactory function was evaluated by the Barcelona Smell Test-24 (BAST-24) olfactometry for smell. detection, identification, and forced choice for first and fifth cranial nerve (CN) dependent odors in comparison to a group of 60 healthy volunteers. In patients with SRH, obstruction was evaluated by peak nasal inspiratory flow (PNIF) and acoustic rhinometry; and nasal inflammation was evaluated by nasal nitric oxide (nNO).Results: Most patients with PER (67%) presented SRH. Moderate/severe PER (84.8%) predominated among patients with SRH, while mild PER (75%) predominated among patients without SRH. Smell detection, identification and forced choice tests were significantly worse in PER patients (P < .05) than in healthy controls for the odors related to the first and fifth CN. Among subgroups, patients with moderate/severe PER and/or with SRH presented a significant reduction in smell detection (P < .05) compared to healthy controls. Nasal NO correlated (R: 0.4; P < .05) with loss of smell.Conclusions: Patients with PER have a moderate loss of smell (BAST-24) with a higher impairment in those with self-reported hyposmia and moderate-to-severe PER. These results suggest that the sense of smell should be further investigated in all patients with allergic rhinitis, both in a clinical setting and in clinical trials: