初诊变应性鼻炎患者临床变应原分析

目的分析初诊为变应性鼻炎患者的变应原检查结果,区别变应性鼻炎(allergic rhinitis,AR)和非变应性鼻炎(non-allergic rhinitis,NAR),指导临床诊断和治疗。方法对门诊2010年1月～2012年3月期间临床症状及体征符合变应性鼻炎的患者833例给予抽血做变应原检查,记录病人性别、年龄、总IgE(total-IgE)、血清特异性IgE(sIgE)、屋尘螨,粉尘螨(HX2)检测结果及吸入性变应原筛查(phadiatop),并对检测结果进行分析。结果初诊833例患者有555例总IgE在参考值以上(>60ku/L),HX2和(或)phadiatop阳性,同时伴有临床症状,可确诊为变应性鼻炎;278例患者总IgE在参考值以内,HX2和(或)phadiatop阴性,但有AR相关临床症状,故诊断为非变应性鼻炎。结论临床有部分变应性鼻炎相关症状的病人(约33.4%)检测相关变应原阴性,故并不能确诊为变应性鼻炎,在临床上应重视行变应原检查,为正确诊断和治疗提供指导。

The allergen analysis for newly diagnosed patients with allergic rhinitis in clinic

Objective Analyze allergens of the outpatients who were diagnosed allergic rhinitis through their symptoms,in order to distinguish allergic rhinitis(AR) and non-allergic rhinitis(NAR),it is important to guide diagnosis and treatment of rhinitis.Methods Drawing blood from the outpatients whose symptoms fit with the guide of the allergic rhinitis,record the patients’ sex,age,total-IgE,serum specific IgE:house dirt mite,dust mite(HX2) and phadiatop.There are 833 patients to be tested from jounary 2010 to may 2012.Results The 833 outpatients are divided two groups,the one include of 555 patients whose total IgE greater than or equal to 60 kul/L,HX2 and padiatop are positive,as well as the symptoms of nasal obstruction,rhinocnesmus,sneeze,running nose,we can have a definite diagnosis to these people for AR;the other is a group of 278 patients whose total IgE less than 60 kul/L,HX2 and padiatop are negative,these people can not to be diagnosed AR,they are diagnosed NAR because of the symptoms described previously.Conclusion According to the guide recently,a great many of patients(33.4%) with symptoms of nasal obstruction,rhinocnesmus,sneezes,running nose can not be diagnosed AR.We should pay more attention to the diagnosis and treatment of rhinitis.