Abstract：
Background: Asthma and chronic obstructive pulmonary disease (COPD) are the most common obstructive diseases. Based on the similarities, we aimed to evaluate sinonasal symptoms in patients with asthma or COPD, and compare the two diseases with regard to upper-airway involvement. Methods: Patients with asthma or with COPD who were followed up at Ankara University Immunology and Allergy or Chest Diseases Departments were included in the study. The participants went through pulmonary function tests, skin-prick tests, and disease severity assessment of either disease. Nasal endoscopic evaluations of all the patients were performed in the Department of Otorhinolaryngology. Lund-Mackay scoring was performed on the computed tomography of the paranasal sinus. Chronic rinosinusitis (CRS) diagnosis was made as recent guidelines. Results: A total of 112 subjects (number of women/men: n = 67/45; median age, 49 years [The range for IQR was 22 years]) were included in the study. Fifty-five patients had asthma, 33 had COPD, and 24 were healthy controls. Nasal symptoms were more frequent in the patients with asthma (patients with asthma, n = 52 [98%]; patients with COPD, n = 17 [52%]; controls, n = 9 [38%]) (p < 0.001). The median (IQR) 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire score was higher in the patients with asthma (33 [20-50]) than in the patients with COPD (8 [1.5-18.7]) and the control group (3.5 [0-18.7]) (p < 0.01). Patients with asthma had significantly higher prevalence rates of rhinosinusitis than did those in the COPD and the control groups (36%, 15.6%, 8.3%, respectively; p < 0.01). The SNOT-22 optimal cutoff score was calculated as ≥11 to detect the score limit for CRS prediction with the best sensitivity and specificity. Conclusion: As a result, patients with both asthma and COPD may have upper-airway symptoms. CRS, was primarily seen in the patients with asthma. Accordingly, SNOT-22 scores were higher in the patients with asthma than in those in the COPD and the control groups. A referral to the Ear Nose Throat department for further evaluation with nasal endoscopy and computed tomography of the paranasal may be required in a subgroup of patients.
摘要：
背景：哮喘和慢性阻塞性肺疾病（COPD）是最常见的阻塞性疾病。基于相似性,我们旨在评估哮喘或COPD患者的鼻窦症状，并比较两种疾病的上呼吸道受累情况。方法：在安卡拉大学免疫学和过敏或胸科随访的哮喘或COPD患者纳入研究。参与者进行了肺功能测试，皮肤点刺试验,以及两种疾病的严重程度评估。所有患者的鼻内镜评估均在耳鼻咽喉科进行。对鼻旁窦的计算机断层扫描进行了Lund-Mackay评分。慢性鼻窦炎（CRS）的诊断作为最近的指南。结果：共有112名受试者（女性/男性人数：n=67/45；中位年龄，49年[IQR的范围为22年])被纳入研究。55名患者患有哮喘,33人患有COPD，24人是健康对照。鼻部症状在哮喘患者中更为常见（哮喘患者，n=52[98%]；COPD患者，n=17[52%]；对照，n=9[38%])(p<0.001)。哮喘患者（33[20-50]）的中位（IQR）22项鼻中结果测试（SNOT-22）问卷得分高于COPD患者（8[1.5-18.7]）和对照组（3.5[0-18.7]）（p<0.01）。哮喘患者的鼻窦炎患病率明显高于COPD和对照组(36%,15.6%,8.3%,分别为；p<0.01)。SNOT-22最佳截止评分计算为≥11，以检测具有最佳灵敏度和特异性的CRS预测的评分极限。结论：结果，同时患有哮喘和COPD的患者可能有上气道症状.CRS,主要见于哮喘患者。因此，哮喘患者的SNOT-22评分高于COPD和对照组。亚组患者可能需要转诊到耳鼻喉部进行鼻内窥镜检查和鼻旁计算机断层扫描的进一步评估。
