Pulmonary Function Changes In Patients With Allergic Rhinitis And Its Impact On Bronchial Asthma

Objective: The purpose of the first part is to determine the impact ofallergic rhinitis （AR） on asthma control and lung function and to analyze thecharacteristic of lung function and airway hyperreactivity （AHR） in patients withAR and their correlation and the influence of glucocorticoid nasal spray on lungfunction and asthma prevention in patients with AR and AHR.Methods:1.63patients with asthma alone or patients with comorbid asthma and ARwere divided into asthma group （n=32） and comorbid asthma and AR group（n=31）. ACT score, ACQ score, and FEV1%, PEF%were compared.（2）Thecorrelation between VAS score and ACT score, ACQ score and lung function wereanalyzed in patients with comorbid asthma and AR.2.38AR patients with AHR⁺_-AR were collected.（1）We analyzed thecharacteristic of lung function.（2）We analyzed the relativity and regressionrelationship between Dmin and lung function.（3） Patients were divided intoFEF25-75%≥80%group （n=13） and FEF25-75%＜80%group （n=25）. Lungfunction were compared.（4） Patients were divided into Dmin＞6.0unit group（n=16） and Dmin≤6.0unit group （n=22）. Lung function were compared.3. The FEF25-75%<80%of the AHR⁺_-AR patients （n=22） were randomlydivided into treatment group （n=11, budesonide nasal spray for12weeks） andcontrol group （n=11, no treatment for12weeks）. Lung function and Dmin beforeand after12weeks in treatment group and between two groups were compared.Results:1.（1）The patients with comorbid asthma and AR had a lower ACT score,lower FEV1%and PEF%than those with asthma alone, whereas ACQ score inpatients with comorbid asthma and AR was higher （P<0.05）.（2）VAS had negative correlation with ACT score, FEV₁%, PEF%, FEF25%and small airwayfunction（FEF50%and FEF25-75%）（P＜0.05）. VAS had positive correlation withACQ score （P＜0.05）.2.（1）76%of AR patients had AHR.10.5%of AHR⁺_-AR patients hadFEV1%＜80%, and42.1%of AHR⁺_-AR patients had small airway dysfunction.（2）Dmin had positive correlation with lung function. Degree of variation in Dmincaused by FEF50%, FEF75%and FEF25-75%was8.3%,5.7%,5.0%.（3）Percentof small airway dysfunction in FEF25-75＜80%group was much higher than thatin FEF25-75＞80%group （P＜0.05）. Lung funciton in FEF25-75＜80%groupwere much lower （P＜0.05）.（4） Percent of small airway dysfunction in Dmin≤6.0unit group was much higher than that in Dmin＞6.0unit group （P＜0.05）. Lungfunciton in Dmin≤6.0unit group were much lower （P＜0.05）.3.（1） After using budesonide nasal spray for12weeks, PEF%, FEF25%,FEF50%and FEF25-75%of AHR⁺_-AR patients were much higher than before （P＜0.05）.（2） After follow-up for12weeks, one patient with AHR⁺_-AR hadoccurred asthma in control group and no patient occurred asthma in treatmentgroup.Conclusion:1. The patients with comorbid asthma and AR experienced more poorasthma control and decreased lung function.2.（1） Small airway dysfunction and AHR are characteristics of part ARpatients.（2） Small airway function had positive correlation with Dmin in patientswith AHR⁺_-AR.The worse small airway function, the lower Dmin.（3）FEF25-75%decline may be an important indicator of the AHR severity in ARpatients.3. Nasal inhaled steroid therapy in the AHR⁺_-AR patients not only canimprove lung function, may also prevent asthma.