Allergic rhinitis and sinusitis in asthma - Differential effects on symptoms and pulmonary function
Allergic rhinitis and sinusitis in asthma - Differential effects on symptoms and pulmonary function
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DOI：
10.1378/chest.130.2.429
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发表时间：
2006-08-01
期刊：
影响因子：
9.6
通讯作者：
Irvin, Charles G.
中科院分区：
文献类型：
--
作者：
Dixon, Anne E.;Kaminsky, David A.;Irvin, Charles G.
背景：变应性鼻炎和鼻窦炎常与哮喘相关。本研究的目的是确定自我报告的过敏性鼻炎和鼻窦炎对大量哮喘患者下呼吸道疾病的影响。方法：美国肺协会-哮喘临床研究中心的两项试验的参与者进行队列研究：2031名哮喘患者参加成人和儿童哮喘灭活疫苗的安全性（SIIVA）试验，488名哮喘患者参加低剂量茶碱作为哮喘附加治疗（LODO）试验。在基线时，参与者报告过敏性鼻炎和鼻窦炎的存在，然后测量肺功能和哮喘控制。在试验期间，对参与者进行哮喘恶化监测。结果：超过70%的参与者报告过敏性鼻炎或鼻窦炎。鼻窦炎多见于女性患者（优势比为1.46 [SIIVA]）、胃食管反流病患者（优势比为2.21 [SIIVA]）和白人患者（优势比为1.53 [SIIVA]）。变应性鼻炎也有类似的关联。患有过敏性鼻炎和鼻窦炎的LODO参与者哮喘症状增加，并且有更多睡眠障碍的趋势。在SIIVA试验中，变应性鼻炎患者的基线肺功能高于无变应性鼻炎患者（91.2% vs 95.8%）。患有鼻窦炎的参与者的肺功能与没有鼻窦炎的参与者相似。有和没有过敏性鼻炎的参与者有相似的加重率。仅在LODO试验中，患有鼻窦炎的受试者哮喘发作增加（5.68例/年vs 3.72例/年）。结论：变应性鼻炎和鼻窦炎与更严重的哮喘症状相关，在哮喘控制不良的患者中，更容易加重，但与肺功能低下无关。
Background: Allergic rhinitis and sinusitis are frequently associated with asthma. The purpose of this study was to determine the impact of self-reported allergic rhinitis and sinusitis on lower airway disease in a large cohort of participants with well-characterized asthma.Methods: A cohort study of participants in two trials of the American Lung Association-Asthma Clinical Research Centers: 2,031 asthmatics in the Safety of Inactivated Influenza Vaccine in Asthma in Adults and Children (SIIVA) trial and 488 asthmatics in the Effectiveness of Low Dose Theophylline as Add-on Treatment in Asthma (LODO) trial. At baseline, participants reported the presence of allergic rhinitis and sinusitis, and then lung function and asthma control were measured. During the trials, participants were monitored for asthma exacerbations.Results: More than 70% of participants reported either allergic rhinitis or sinusitis. Sinusitis was more common in female patients (odds ratio, 1.46 [SIIVA]), those with gastroesophageal reflux disease (odds ratio, 2.21 [SIIVA]), and those of white race (odds ratio, 1.53 [SIIVA]). Similar associations were seen for allergic rhinitis. LODO participants with allergic rhinitis and sinusitis had increased asthma symptoms and a trend toward more sleep disturbance. Participants with allergic rhinitis had higher baseline lung function than those without allergic rhinitis measured by peak flow (91.2% vs 95.8% in the SIIVA trial). Participants with sinusitis had similar lung function to those without sinusitis. Participants with and without allergic rhinitis had similar exacerbation rates. In the LODO trial only, participants with sinusitis had increased asthma exacerbations (5.68 per patient per year vs 3.72 per patient per year).Conclusion: Allergic rhinitis and sinusitis are associated with more severe asthmatic symptoms and, in patients with poorly controlled asthma, more exacerbations but are not associated with low lung function.