-
摘要: 目的：探索过敏因素在儿童急性急性鼻-鼻窦炎（ARS）中所发挥的作用，并对伴或不伴过敏的ARS患儿进行症状评估。方法：2016-06-2018-01期间选择207例4~12岁ARS患儿以及85例对照组儿童，利用问卷调查采集受试者基本信息，记录患儿皮肤点刺试验（SPT）结果，由ARS患儿母亲填写儿童鼻窦炎生活质量量表（SN-5）。根据SPT结果将ARS患儿分为ARS伴过敏组和ARS不伴过敏组。分析2组患儿参数之间的不同。结果：在207例ARS患儿中，44.4%的患儿对至少1种吸入性变应原过敏，40.6%的患儿对至少1种常年性变应原过敏，均显著高于对照组，对常年性变应原过敏比对季节性变应原过敏更常见。在ARS伴过敏组患儿中鼻塞（5.28±1.34）、鼻涕（5.07±1.04）、鼻后滴漏（4.63±1.31）和鼻（眼）痒（4.28±1.51）是最为严重的4个症状。过敏组患儿的鼻塞症状、过敏症状、情绪症状以及行为症状4个子量表的评分均显著高于非过敏组患儿。结论：过敏因素在儿童ARS发病机制中发挥了重要作用。Abstract: Objective: To explore the prevalence of allergy in patients with acute rhinosinusitis (ARS) and evaluate the severity of symptoms in ARS children with or without allergy.Method: Two hundred and seven children (4-12 years of age) with ARS and 85 children of control group were included in our research from June, 2016 to January, 2018. We use questionaire to collect the basic information of pediatric patients. The results of skin prick test (SPT) were recorded. Mothers were required to complete the Sinus and Nasal Quality-of-Life Survey (SN-5).All ARS childern were divided into allergic group and non-allergic group according to the result of SPT. We use binomial distribution to evaluate the population rate. t-test, Chi-square test and Wilcoxon rank-sum test were appropriately used to compare the parameters between two groups.Result: Among the 207 ARS participants in this study, 44.4% participants were shown to response to at least one Inhalation allergen and 40.6% participants were shown to response to at least one perennial allergen. Both ratios were significantly higher than those of the control group. Perennial allergy seems to be much more common than seasonal allergy in pediatric patients with ARS. The most troublesome symptoms among the participants with acute rhinosinusitis combined with allergic rhinitis were nasal obstruction (5.28±1.34), nasal discharge (5.07±1.04), post-nasal drip (4.63±1.31) and itchy eyes/nose (4.28±1.51). Four subscale scores of the SN-5 including nasal obstruction, allergy symptoms, emotional distress and activity limitation in the allergic group were obviously higher than those of the non-allergic group.Conclusion: Allergic factors play an important role in the pathogenesis of pediatric acute rhinosinusitis.
-
Key words:
- sinusitis /
- allergens /
- child /
- rhinitis, allergic
-
-
[1] FOKKENS W J, LUND V J, MULLOL J, et al.European Position Paper on Rhinosinusitis and Nasal Polyps 2012[J].Rhinol Suppl, 2012, 23:1-298.
[2] VELING M C.The role of allergy in pediatric rhinosinusitis[J].Curr Opin Otolaryngol Head Neck Surg, 2013, 21:271-276.
[3] BLAIR C, NELSON M, THOMPSON K, et al.Allergic inflammation enhances bacterial sinusitis in mice[J].J Allergy Clin Immunol, 2001, 108:424-429.
[4] MAHAKIT P, PUMHIRUN P.A preliminary study of nasal mucociliary clearance in smokers, sinusitis and allergic rhinitis patients[J].Asian Pac J Allergy Immunol, 1995, 13:119-121.
[5] ANDERSEN I, PROCTOR D F.Measurement of nasal mucociliary clearance[J].Eur J Respir Dis Suppl, 1983, 127:37-40.
[6] EMANUEL I A, SHAH S B.Chronic rhinosinusitis:allergy and sinus computed tomography relationships[J].Otolaryngol Head Neck Surg, 2000, 123:687-691.
[7] HUANG S W.The risk of sinusitis in children with allergic rhinitis[J].Allergy Asthma Proc, 2000, 21:85-88.
[8] STEINKE J W, BORISH L.The role of allergy in chronic rhinosinusitis[J].Immunol Allergy Clin North Am, 2004, 24:45-57.
[9] LINA S W, LEE M Y, KU M S, et al.Clinical spectrum of acute rhinosinusitis among atopic and nonatopic children in Taiwan[J], Int J Pediatric Otorhinolaryngol, 2012, 76:70-75.
[10] LEO G, INCORVAIA C, CAZZAVILLAN A, et al.Could seasonal allergy be a risk factor for acute rhinosinusitis in children[J]?J Laryngol Otol, 2018, 132:150-153.
[11] KAY D J, ROSENFELD R M.Quality of life for children with persistent sinonasal symptoms[J].Otolaryngol Head Neck Surg, 2003, 128:17-26.
[12] RAMADAN H H, FORNELLI R, ORTIZ A O, et al.Correlation of allergy and severity of sinus disease[J].Am J Rhinol, 1999, 13:345-347.
[13] NACLERIO R M, DETINEO M L, BAROODY F M.Ragweed allergic rhinitis and the paranasal sinuses.A computed tomographic study[J].Arch otolaryngol Head Neck Surg, 1997, 123:193-193.
[14] GUTMAN M, TORRES A, KEEN K J, et al.Prevalence of allergy in patients with chronic rhinosinusitis[J] Otolaryngol Head Neck Surg, 2004, 130:545-552.
[15] MAHAKIT P, PUMHIRUN P.A preliminary study of nasal mucociliary clearance in smokers, sinusitis and allergic rhinitis patients[J] Asian Pacific J Allergy Immunol, 1995, 13:119-121.
[16] GUTMAN M, TORRES A, KEEN K J, et al.Prevalence of allergy in patients with chronic rhinosinusitis[J].Otolaryngol Head Neck Surg, 2004, 130:545-552.
[17] ALHO O P.Nasal airflow, mucociliary clearance, and sinus functioning during viral colds:effects of allergic rhinitis and susceptibility to recurrent sinusitis[J].Am J Rhinol, 2004, 18:349-350.
[18] ZHOU R Y, WANG J J, SUN J C, et al.Attention deficit hyperactivity disorder may be a highly inflammation and immune-associated disease (Review)[J].Mol Med Rep, 2017, 16:5071-5077.
[19] YANG C F, YANG, C C, WANG I J.Association between allergic diseases, allergic sensitization and attention-deficit/hyperactivity disorder in children:a large-scale, population-based study[J].J Chin Med Assoc, 2018, 81:277-283.
[20] SCHANS J V, CICEK R, DE VRIES T W, et al.Association of atopic diseases and attention-deficit/hyperactivity disorder:a systematic review and meta-analyses[J], Neurosci Biobehav Rev, 2017, 74:139-148.
[21] FENG B, JIN H, XIANGH, et al.Association of pediatric allergic rhinitis with the ratings of attention-deficit/hyperactivity disorder[J] Am J Rhinol Allergy, 2017, 31:161-167.
[22] BRAWLEY A, SILVERMAN B, KEARNEYS, et al.Allergic rhinitis in children with attention-deficit/hyperactivity disorder[J].Ann Allergy Asthma Immunol, 2004, 92:663-667.
-
计量
- 文章访问数: 69
- PDF下载数: 58
- 施引文献: 0
下载: