变应性鼻炎患者鼻塞评估指标与心理特征及生活质量的相关性分析

Correlation analysis of evaluation indicators of nasal obstruction, psychological characteristics and quality of life in patients with allergic rhinitis

摘要:

目的 探讨变应性鼻炎（AR）患者鼻塞主/客观评估指标与心理状态的相关性，分析鼻塞主/客观评估不一致人群的临床特征。方法 回顾性分析北京市海淀医院2025年1月—2025年10月收治的100例AR患者的临床资料，采用视觉模拟评分法（VAS）、鼻症状总评分（TNSS）、鼻炎生活质量问卷（RQLQ）及鼻炎伴随症状总评分（TNNSS）评估患者的主观症状；采用抑郁自评量表（SDS）、焦虑自评量表（SAS）评估患者的心理状态；以鼻腔有效阻力、鼻腔容积、鼻腔最小横截面积等作为鼻通气功能的客观评估指标。采用Spearman相关性分析探讨各指标间的相关性。结果 患者VAS评分为（6.18±2.35）分，RQLQ总分为（86.20± 36.46）分，SDS标准分为（50.28± 11.74）分，SAS标准分为（45.99±11.42）分。鼻腔有效阻力为（1.00±0.38）Pa/(cm³·s)，鼻声反射0~7 cm段鼻腔容积为（8.75±3.52）cm³，鼻声反射2~6 cm段鼻腔容积为（4.93±2.29）cm^{3，鼻腔最小横截面积为（0.43}±0.27）cm²。Spearman相关性分析显示，鼻腔有效阻力与SDS标准分（r=0.375，P< 0.01）、SAS标准分（r= 0.273，P< 0.01）、VAS评分（r=0.302，P<0.01）呈正相关；SDS标准分与TNSS评分（r= 0.387，P<0.01）、TNNSS评分（r= 0.353，P<0.01）呈正相关；SAS标准分与VAS评分（r=0.316，P<0.01）、TNSS评分（r=0.334，P< 0.01）呈正相关。主/客观鼻塞不一致患者中RQLQ总分与鼻声反射2~6 cm段鼻腔容积（r=0.722，P<0.01）、鼻腔最小横截面积（r=0.601，P< 0.05）呈正相关，SDS标准分与TNSS评分（r=-0.650，P<0.05）、TNNSS评分（r=-0.569，P< 0.05）呈负相关。结论 AR患者鼻塞客观通气指标与心理状态、主观症状及生活质量密切相关，而主/客观鼻塞评估不一致患者其相关性模式独特。临床评估AR患者时，应综合考虑主/客观鼻塞通气指标及心理状态，对主/客观不一致患者需重点关注其潜在的心理因素。

Abstract:

Objective To investigate the correlation between subjective and objective assessment indicators of nasal obstruction and psychological status in patients with allergic rhinitis (AR), and to analyze the characteristics of patients with subjective-objective discordance.Methods Clinical data of 100 AR patients admitted to Haidian Hospital, Beijing from January 2025 to October 2025 were retrospectively analyzed. Subjective symptoms were assessed using the visual analogue scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), total nasal symptom score (TNSS), and total non-nasal symptom score (TNNSS). Psychological status was evaluated using the self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Objective nasal ventilation function was assessed through nasal effective resistance, nasal cavity volume, and minimal cross-sectional area. Spearman correlation analysis was employed to explore the relationships among these indicators.Results The VAS score of the AR patients was (6.18±2.35), RQLQ total score was (86.20±36.46), SDS standard score was (50.28±11.74), and SAS standard score was (45.99±11.42). The nasal effective resistance was (1.00±0.38) Pa/(cm³·s), nasal cavity volume 0~7 cm was (8.75±3.52) cm³, nasal cavity volume 2~6 cm was (4.93±2.29) cm³, and minimal cross-sectional area was (0.43±0.27) cm². Spearman correlation analysis showed that nasal airway resistance was significantly positively correlated with SDS score (r=0.375, P<0.01), SAS score (r=0.273, P<0.01), and VAS score (r=0.302, P<0.01). SDS score was significantly positively correlated with TNSS score (r=0.387, P<0.01) and TNNSS score (r=0.353, P<0.01). SAS score was significantly positively correlated with VAS score (r=0.316, P<0.01) and TNSS score (r=0.334, P<0.01). In patients with subjective-objective nasal obstruction discordance, only RQLQ total score was positively correlated with nasal cavity volume 2~6 cm (r=0.722, P<0.01) and minimal cross-sectional area (r=0.601, P<0.05), while SDS score was negatively correlated with TNSS score (r=-0.650) and TNNSS score (r=-0.569) (P<0.05).Conclusions Objective nasal obstruction indicators are closely correlated with psychological status, subjective symptoms, and quality of life in AR patients, whereas these correlations unique mode in patients with subjective-objective nasal obstruction discordance. Clinical evaluation of AR patients should integrate both subjective and objective nasal obstruction indicators along with psychological status, and potential psychological factors should be considered in patients with subjective-objective discordance.