CAJ | 학술논문

目的：慢性鼻炎临床上分为可明确过敏原的变应性鼻炎和过敏原不明确的非变应性鼻炎。文中探求不同类型鼻炎对下气道炎症影响的差异，以利于更好地认识并干预不同类型鼻炎对于下气道炎症的影响。方法收集2010年1月至12月初次在南京军区南京总医院耳鼻咽喉-头颈外科就诊的鼻炎患者共639例。依据鼻炎诊断标准将受试者分为变应性鼻炎（allergic rhinitis， AR）组377例、非变应性鼻炎（nonallergic rhinitis， NAR）组262例，以及264例无鼻炎症状患者作为健康对照组。分别进行乙酰甲胆碱支气管激发试验、呼出气一氧化氮及诱导痰炎症细胞分类检测，明确不同类型鼻炎患者下气道炎症的特征和差异。结果 AR组和NAR组患者FeNO阳性率的差异有统计学意义（37．93％vs 20．99％， P＜0．05）；支气管激发试验阳性率的差异有统计学意义（12．20％vs 6．10％， P＜0．05）；诱导痰EOS计数差异有统计学意义[2．00（0．25，7．10） vs 0．50（0．00，1．71）， P＜0．05]，但诱导痰阳性率差异无统计学意义（P＞0．05）。结论 AR和NAR均可能加重患者的下气道嗜酸细胞炎症和气道高反应性，需要进行治疗和干预，而AR对下气道炎症的影响比NAR作用更强。
목적：만성비염림상상분위가명학과민원적변응성비염화과민원불명학적비변응성비염。문중탐구불동류형비염대하기도염증영향적차이，이리우경호지인식병간예불동류형비염대우하기도염증적영향。방법수집2010년1월지12월초차재남경군구남경총의원이비인후-두경외과취진적비염환자공639례。의거비염진단표준장수시자분위변응성비염（allergic rhinitis， AR）조377례、비변응성비염（nonallergic rhinitis， NAR）조262례，이급264례무비염증상환자작위건강대조조。분별진행을선갑담감지기관격발시험、호출기일양화담급유도담염증세포분류검측，명학불동류형비염환자하기도염증적특정화차이。결과 AR조화NAR조환자FeNO양성솔적차이유통계학의의（37．93％vs 20．99％， P＜0．05）；지기관격발시험양성솔적차이유통계학의의（12．20％vs 6．10％， P＜0．05）；유도담EOS계수차이유통계학의의[2．00（0．25，7．10） vs 0．50（0．00，1．71）， P＜0．05]，단유도담양성솔차이무통계학의의（P＞0．05）。결론 AR화NAR균가능가중환자적하기도기산세포염증화기도고반응성，수요진행치료화간예，이AR대하기도염증적영향비NAR작용경강。
Objective To describe the effects of allergic and nonallergic rhinitis on patients with bronchial inflammation by comparing the bronchial inflammation characteristics . Methods All patients enrolled in the study were categorized into two groups according to rhinitis diagnostic criteria , 377 cases in the allergic rhinitis ( AR) group, 262 cases in non-allergic rhinitis ( NAR) group and another 264 patients without rhinitis as control group .Induced sputum differential cytology tests , exhaled nitric oxide concentration measurements and methacholine bronchial provocation tests were performed .The characteristics and differences in lower airway inflam-mation among the three groups were compared . Results The exhaled nitric oxide level and the positive rate of the exhaled nitric ox-ide were different significantly in AR group and NAR group than the control group (P<0.05);Bronchial provocation positive rate was 12.20%in AR group, and 6.10%in the NAR group, the difference was significant (P<0.05), and the levels in the two groups were significantly higher than the control group (P<0.05).AR group and NAR group has a significant different (P<0.05) propor-tions of eosinophil in induced sputum , while the positive rate of eosinophil in induced sputum was not different significantly ( P >0.05). Conclusion Bronchial inflammation may be aggravated by AR and NAR , so all patients with AR and NAR need treatment , and the degree of inflammation was higher in AR patients than the NAR patients .