变应性鼻炎症状学及生活质量影响的性别特异性差异：一项横断面研究

文献信息

中文摘要

背景： 变应性鼻炎（AR）是一种广泛存在的疾病，显著影响全球患者的生活质量（QOL）。它可导致睡眠障碍、疲劳、注意力不集中、易激惹，并可加重合并哮喘个体的症状。本研究探讨AR对成人QOL的影响，并特别关注性别差异。
材料与方法： 采用目的设计的非验证性问卷开展横断面在线调查，通过社交媒体以便利抽样方式发放给1572名约旦成人。问卷收集人口学资料、AR症状、诱因以及AR对心理健康、社会功能和日常生活影响的数据。数据采用描述性统计和卡方检验进行分析。使用多变量logistic回归校正潜在混杂因素，并应用Benjamini-Hochberg错误发现率（FDR）校正以处理多重比较。
结果： 共1572名受访者参与；683名（43.4%）患有医生诊断的AR。AR在男性中报告率为157/419（37.5%），女性为526/1153（45.6%）；该性别差异具有统计学意义（χ2 = 8.31，p = 0.004；OR = 1.40，95% CI 1.11-1.76）。大多数患者居住在城市地区（69.4%）。虽然打喷嚏和流涕在两性中均常见，但女性报告鼻痒/鼻塞（55.5% vs. 43.9%，p = 0.011）、头痛（61.0% vs. 43.9%，p < 0.001）以及压力/焦虑增加（53.4% vs. 42.7%，p = 0.018，未通过错误发现率（FDR）校正）的比例显著更高。相反，打鼾在男性中更为普遍（40.1% vs. 24.1%，p < 0.001）。关于QOL，AR严重干扰两性的睡眠（80.7%）和注意力（66.2%）。然而，女性显著更可能报告易激惹/情绪困扰（65.4% vs. 55.4%，p = 0.023）、症状期间偏好社交隔离（59.3% vs. 47.8%，p = 0.010）以及户外活动受限（55.1% vs. 45.9%，p = 0.041）。校正后，女性性别仍与易激惹/情绪困扰（aOR = 1.50，95% CI 1.02-2.22，p = 0.039）和偏好社交隔离（aOR = 1.53，95% CI 1.05-2.23，p = 0.028）显著相关。经Benjamini-Hochberg FDR校正后，鼻痒/鼻塞、打鼾和头痛在症状分析中仍具有统计学意义；无QOL条目通过FDR校正，这些发现应视为探索性。80/683（11.7%）的AR患者报告哮喘，男性多于女性（19.7% vs. 9.3%，p < 0.001）。敏感性分析显示，女性性别与社交隔离的关联在校正或排除哮喘后仍稳健，而与易激惹的关联在排除哮喘参与者后减弱。
结论： 这些发现提示AR对日常功能和精神健康有显著影响，并显示女性心理社会负担更重的信号。更好地理解性别特异性挑战可支持更有效的预防、诊断和管理策略，并采取量身定制的策略以应对女性患者所经历的独特症状负担和QOL损害。这些发现可能为约旦AR负担提供初步见解，并应在具有代表性的验证性调查中予以证实。

英文摘要

BACKGROUND: Allergic Rhinitis (AR) is a widespread condition that significantly affects the quality of life (QOL) of those affected globally. It contributes to sleep disturbances, fatigue, poor concentration, irritability, and can worsen symptoms in individuals with coexisting asthma. This study examines the impact of AR on QOL in adults, with specific attention to sex differences.
MATERIALS AND METHODS: A cross-sectional online survey using a purpose-designed, non-validated questionnaire was distributed via social media using convenience sampling to 1572 Jordanian adults. The questionnaire collected data on demographics, AR symptoms, triggers, and the impact of AR on mental health, social functioning, and daily life. Data were analyzed using descriptive statistics and Chi-square tests. Multivariable logistic regression was used to adjust for potential confounders, and Benjamini-Hochberg false discovery rate (FDR) correction was applied to account for multiplicity.
RESULTS: A total of 1572 respondents participated; 683 (43.4%) had physician-diagnosed AR. AR was reported by 157/419 males (37.5%) and 526/1153 females (45.6%); this sex difference was statistically significant (χ2 = 8.31, p = 0.004; OR = 1.40, 95% CI 1.11-1.76). Most patients lived in urban areas (69.4%). While sneezing and rhinorrhoea were common across sexes, females reported significantly higher rates of nasal itching/congestion (55.5% vs. 43.9%, p = 0.011), headaches (61.0% vs. 43.9%, p < 0.001), and increased stress/anxiety (53.4% vs. 42.7%, p = 0.018, not surviving false discovery rate (FDR) correction). In contrast, snoring was more prevalent in males (40.1% vs. 24.1%, p < 0.001). Regarding QOL, AR severely disrupted sleep (80.7%) and concentration (66.2%) for both sexes. However, females were significantly more likely to report irritability/emotional distress (65.4% vs. 55.4%, p = 0.023), prefer social isolation during symptoms (59.3% vs. 47.8%, p = 0.010), and experience limitations in activities outside the home (55.1% vs. 45.9%, p = 0.041). After adjustment, female sex remained significantly associated with irritability/emotional distress (aOR = 1.50, 95% CI 1.02-2.22, p = 0.039) and preference for social isolation (aOR = 1.53, 95% CI 1.05-2.23, p = 0.028). After Benjamini-Hochberg FDR correction, nasal itching/congestion, snoring, and headache remained statistically significant in symptom analyses; no QOL items survived FDR correction, and these findings should be considered exploratory. Asthma was reported by 80/683 (11.7%) of AR patients, more frequently among males than females (19.7% vs. 9.3%, p < 0.001). Sensitivity analyses showed that the association between female sex and social isolation was robust to adjustment for or exclusion of asthma, whereas the association with irritability was attenuated after excluding participants with asthma.
CONCLUSION: These findings suggest AR's substantial impact on daily functioning and mental well-being, with signals of greater psychosocial burden among women. Improved understanding of sex-specific challenges can support more effective prevention, diagnosis, and management strategies, with tailored strategies to address the distinct symptom burden and QOL impairments experienced by female patients. These findings may provide preliminary insights into the burden of AR in Jordan and should be confirmed in representative, validated surveys.