盘锦地区过敏性鼻炎患者临床特征调查
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摘要
目的调查盘锦地区过敏性鼻炎(AR)确诊患者的症状特点、治疗情况、伴发疾病以及致敏变应原特征。方法以2017年3月～2018年2月到盘锦市中心医院耳鼻咽喉科就诊的经血清特异性IgE确诊的AR患者作为研究入组对象,借助专门设计的问卷详尽收集患者的病史资料。结果共入组613例AR确诊患者,35岁之前男性患者数量超过女性,35岁以后女性患者更多;46%患者在8月和9月集中就诊;根据症状和持续时间分类,轻度间歇性AR 15.0%,轻度持续性AR 14.7%,中重度间歇性AR 18.1%,中重度持续性AR 52.2%;轻度间歇性AR患者很少使用药物治疗(59.8%),中重度持续性AR比例最低(30.6%),跟前者相比,后者常常会在有症状时使用药物(49.7%vs 29.3%),各亚型AR患者药物使用的情况存在统计学差异(χ~2=29.09,P<0.01);症状自报率:喷嚏77.0%,鼻塞59.1%,清水涕53.5%,鼻痒49.6%,眼痒48.0%,溢泪31.8%。鼻塞是持续性AR患者的常见症状(χ~2=14.39,P<0.01),喷嚏和鼻痒症状更多见于间歇性AR患者(χ~2=27.15,P<0.01;χ~2=9.03,P=0.03)。结论全面了解盘锦地区AR门诊患者的临床特征,为未来的预防和诊治制定有效的临床决策提供科学依据。
OBJECTIVE To investigate the characteristics of symptoms, treatment, cormorbities and sensitized allergens in allergic rhinitis(AR) patients from city Panjin. METHODS AR patients diagnosed by serum speci?c IgE from March 2017 to February 2018 in department of otolaryngology in Panjin Central Hospital were enrolled in this study, and their medical history data were collected in detail by means of specially designed questionnaires. RESULTS A total of 613 AR patients were enrolled in the study, the number of male patients was higher than that of female patients before 35 years old, the number of female patients was higher after 35 years old; 46% of outpatients concentrated in August and September; according to the classification of symptoms and duration, mild intermittent 15.0%, mild persistent 14.7%,moderate-severe intermittent 18.1%, moderate-severe persistent52.2%; mild intermittent patients rarely used medication(59.8%)and the percentage of moderate-severe intermittent was the lowest(30.6%). Compared with the former, the latter often used drugs when symptoms were present(49.7% vs 29.3%).There were statistical differences in dr ug use among patients with various subtypes of AR(χ~2=29.09, P <0.01);the self-reported rate of symptoms: sneezing(77.0%), nasal obstruction(59.1%), rhinorrhea(53.5%), nasal itching(49.6%),eye itching(48.0%) and watery eye(31.8%). Nasal obstruction is a more common symptom in patients with persistent AR(χ~2=14.39, P <0.01). Sneezing and nasal itching are more common in patients with intermittent AR(χ~2=27.15, P <0.01;χ~2=9.03, P=0.03). CONCLUSION To fully understand the clinical characteristics of AR outpatients in city Panjin, and to provide scienti?c data for future prevention and treatment and effective clinical decision-making.
OBJECTIVE To investigate the characteristics of symptoms, treatment, cormorbities and sensitized allergens in allergic rhinitis(AR) patients from city Panjin. METHODS AR patients diagnosed by serum speci?c IgE from March 2017 to February 2018 in department of otolaryngology in Panjin Central Hospital were enrolled in this study, and their medical history data were collected in detail by means of specially designed questionnaires. RESULTS A total of 613 AR patients were enrolled in the study, the number of male patients was higher than that of female patients before 35 years old, the number of female patients was higher after 35 years old; 46% of outpatients concentrated in August and September; according to the classification of symptoms and duration, mild intermittent 15.0%, mild persistent 14.7%,moderate-severe intermittent 18.1%, moderate-severe persistent52.2%; mild intermittent patients rarely used medication(59.8%)and the percentage of moderate-severe intermittent was the lowest(30.6%). Compared with the former, the latter often used drugs when symptoms were present(49.7% vs 29.3%).There were statistical differences in dr ug use among patients with various subtypes of AR(χ~2=29.09, P <0.01);the self-reported rate of symptoms: sneezing(77.0%), nasal obstruction(59.1%), rhinorrhea(53.5%), nasal itching(49.6%),eye itching(48.0%) and watery eye(31.8%). Nasal obstruction is a more common symptom in patients with persistent AR(χ~2=14.39, P <0.01). Sneezing and nasal itching are more common in patients with intermittent AR(χ~2=27.15, P <0.01;χ~2=9.03, P=0.03). CONCLUSION To fully understand the clinical characteristics of AR outpatients in city Panjin, and to provide scienti?c data for future prevention and treatment and effective clinical decision-making.
引文
[1] Greiner AN, Hellings PW, Rotiroti G, et al. Allergic rhinitisLancet,2011,378(9809):2112-2122.
[2] Bousquet J, Khaltaev N, Cruz AA,et al. Allergic Rhinitis and its Impact on Asthma(ARIA)2008 update(in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy,2008, 63 Suppl 86:8-160.
[3] Canonica GW, Bousquet J, Mullol J, et al-A survey of the burden of allergic rhinitis in Europe. Allergy, 2007, 62 Suppl 85:17-25.
[4] Schatz M-A survey of the burden of allergic rhinitis in the USAAllergy, 2007, 62 Suppl 85:9-16.
[5] Jauregui I,Da vila I,Sastre J,et al-Validation of ARIA(Allergic Rhinitis and its Impact on Asthma)classification in a pediatric population:the PEDRIAL study. Pediatr Allergy Immunol, 2011,22(4):388-392.
[6] He S,Li YJ,Chen J-Clinical features of allergic rhinitis in children of Shanghai, China. Genet Mol Res, 2016, 15(2).
[7] Chen J, Zhao Y, Li B, et al-A multicenter study of the clinical features of allergic rhinitis in central China. Am J Rhinol Allergy, 2014, 28(5):392-396.
[8]李琳,安立峰,魏君,等·吉林省变应性鼻炎患者临床特征·中国耳鼻咽喉头颈外科,2010, 17(12):619-621-
[9]徐红利,张启成,胡松群,等·江苏南通地区变应性鼻炎患者的临床特征分析.临床耳鼻咽喉头颈外科杂志,2017, 31(01):30-33-
[10]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组;中华医学会耳鼻咽喉头颈外科学分会鼻科学组·变应性鼻炎诊断和治疗指南(2015年,天津)·中华耳鼻咽喉头颈外科杂志,2016, 51(1):6-24.
[11] Olivieri M, Verlato G, Corsico A, et al-Prevalence and features of allergic rhinitis in Italy. Allergy,2002, 57(7):600-606.
[12]陈建军,孔维佳,项济生,等·变应性鼻炎与非感染性非变应性鼻炎临床特征分析·中国耳鼻咽喉头颈外科,2008, 15(3):137-141-
[13] Nihle n U, Greiff L, Montne mery P, et al-Incidence and remissionof self-reported allergic rhinitis symptoms in adults. Allergy,2006,61(11):1299-1304.
[14] Wang XD, Zheng M, Lou HF, et al-An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005to 2011. Allergy,2016, 71(8):1170-1180-
[15] Bousquet PJ, Bousquet-Rouanet L, Co MHB, et al. ARIA(Allergic Rhinitis and Its Impact on Asthma)classification of allergic rhinitis severity in clinical practice in France. Int Arch Allergy Immunol,2007, 143(3):163-169.
[16]王志颐,张勇,陈伟,等.变应性鼻炎和非变应性鼻炎临床特征比较·中国耳鼻咽喉颅底外科杂志,2011,17(5):340-343.
[17] White P, Smith H, Baker N, et al-Symptom control in patients with hay fever in UK general practice:how well are we doing and is there a need for allergen immunotherapy. Clin Exp Allergy,1998, 28(3):266-270-
[18] Hankin CS, Cox L, Bronstone A, et al. Allergy immunotherapy:reduced health care costs in adults and children with allergic rhinitis. J Allergy Clin Immunol,2013, 131(4):1084-1091-
[19] Cardell LO, Olsson P, Andersson M, et al-TOTALL:high cost of allergic rhinitis-a national Swedish population-based questionnaire study. NPJ Prim Care Respir Med, 2016, 26:15082-
[20] Deb A, Mukherjee S, Saha BK, et al. Profile of Patients with Allergic Rhinitis(AR):A Clinic Based Cross-Sectional Study from Kolkata,India. J Clin Diagn Res,2014, 8(1):67-70.
[21] Lee CH, Jang JH, Lee HJ, et al-Clinical characteristics of allergic rhinitis according to allergic rhinitis and its impact on asthma guidelines. Clin Exp Otorhinolaryngol,2008, 1(4):196-200.
[2] Bousquet J, Khaltaev N, Cruz AA,et al. Allergic Rhinitis and its Impact on Asthma(ARIA)2008 update(in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy,2008, 63 Suppl 86:8-160.
[3] Canonica GW, Bousquet J, Mullol J, et al-A survey of the burden of allergic rhinitis in Europe. Allergy, 2007, 62 Suppl 85:17-25.
[4] Schatz M-A survey of the burden of allergic rhinitis in the USAAllergy, 2007, 62 Suppl 85:9-16.
[5] Jauregui I,Da vila I,Sastre J,et al-Validation of ARIA(Allergic Rhinitis and its Impact on Asthma)classification in a pediatric population:the PEDRIAL study. Pediatr Allergy Immunol, 2011,22(4):388-392.
[6] He S,Li YJ,Chen J-Clinical features of allergic rhinitis in children of Shanghai, China. Genet Mol Res, 2016, 15(2).
[7] Chen J, Zhao Y, Li B, et al-A multicenter study of the clinical features of allergic rhinitis in central China. Am J Rhinol Allergy, 2014, 28(5):392-396.
[8]李琳,安立峰,魏君,等·吉林省变应性鼻炎患者临床特征·中国耳鼻咽喉头颈外科,2010, 17(12):619-621-
[9]徐红利,张启成,胡松群,等·江苏南通地区变应性鼻炎患者的临床特征分析.临床耳鼻咽喉头颈外科杂志,2017, 31(01):30-33-
[10]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组;中华医学会耳鼻咽喉头颈外科学分会鼻科学组·变应性鼻炎诊断和治疗指南(2015年,天津)·中华耳鼻咽喉头颈外科杂志,2016, 51(1):6-24.
[11] Olivieri M, Verlato G, Corsico A, et al-Prevalence and features of allergic rhinitis in Italy. Allergy,2002, 57(7):600-606.
[12]陈建军,孔维佳,项济生,等·变应性鼻炎与非感染性非变应性鼻炎临床特征分析·中国耳鼻咽喉头颈外科,2008, 15(3):137-141-
[13] Nihle n U, Greiff L, Montne mery P, et al-Incidence and remissionof self-reported allergic rhinitis symptoms in adults. Allergy,2006,61(11):1299-1304.
[14] Wang XD, Zheng M, Lou HF, et al-An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005to 2011. Allergy,2016, 71(8):1170-1180-
[15] Bousquet PJ, Bousquet-Rouanet L, Co MHB, et al. ARIA(Allergic Rhinitis and Its Impact on Asthma)classification of allergic rhinitis severity in clinical practice in France. Int Arch Allergy Immunol,2007, 143(3):163-169.
[16]王志颐,张勇,陈伟,等.变应性鼻炎和非变应性鼻炎临床特征比较·中国耳鼻咽喉颅底外科杂志,2011,17(5):340-343.
[17] White P, Smith H, Baker N, et al-Symptom control in patients with hay fever in UK general practice:how well are we doing and is there a need for allergen immunotherapy. Clin Exp Allergy,1998, 28(3):266-270-
[18] Hankin CS, Cox L, Bronstone A, et al. Allergy immunotherapy:reduced health care costs in adults and children with allergic rhinitis. J Allergy Clin Immunol,2013, 131(4):1084-1091-
[19] Cardell LO, Olsson P, Andersson M, et al-TOTALL:high cost of allergic rhinitis-a national Swedish population-based questionnaire study. NPJ Prim Care Respir Med, 2016, 26:15082-
[20] Deb A, Mukherjee S, Saha BK, et al. Profile of Patients with Allergic Rhinitis(AR):A Clinic Based Cross-Sectional Study from Kolkata,India. J Clin Diagn Res,2014, 8(1):67-70.
[21] Lee CH, Jang JH, Lee HJ, et al-Clinical characteristics of allergic rhinitis according to allergic rhinitis and its impact on asthma guidelines. Clin Exp Otorhinolaryngol,2008, 1(4):196-200.