鼻敏片治疗常年性变应性鼻炎的疗效观察

目的观察鼻敏片对常年性变应性鼻炎的临床疗效。方法43例常年性变应性鼻炎随机分为两组，鼻敏片组23例，安慰剂组20例，观察治疗前后患者的临床症状、体征、变应原皮肤滴定试验的变化。结果鼻敏片组临床疗效明显优于对照组（P〈0．01），变应原皮肤滴定试验风团改善明显（P〈0．05）。结论鼻敏片对变应性鼻炎具有良好的临床疗效。     

沈阳地区变应性鼻炎患者变应原调查

目的 了解沈阳地区变应性鼻炎患者变应原分布特点.方法 收集1408例变应性鼻炎患者,采用14种标准化变应原行皮肤点刺试验检测,并将患者按年龄分组,比较其在变应原阳性率分布上的差异.结果 1408例变应性鼻炎变应原皮肤点刺试验阳性率前3位分别为:粉尘螨78.20％(1101/1408)、屋尘螨74.01％(1042/1408)、艾蒿56.61％(797/1408);儿童组中常见变应原的阳性率明显高于成人组(x2检验,P＜0.05).结论 尘螨是沈阳地区变应性鼻炎的最主要变应原.     

变应性因素对鼻内镜手术疗效的影响

目的：探讨变应性因素对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术疗效的影响。方法对我院2011～2012年入院手术的II型慢性鼻窦炎伴鼻息肉患者,术前根据其是否伴有变应性鼻炎症状和体征、是否伴有过敏性疾病史及支气管哮喘病史、术前鼻腔分泌物涂片嗜酸粒细胞检查、变应原皮肤试验、血清特异性IgE检查、过敏性鼻炎,筛选出伴有变应性因素的慢性鼻窦炎伴鼻息肉患者为试验组。选择同期无变应性因素的单纯慢性鼻窦炎伴鼻息肉患者作为对照组。比较两组患者手术后疗效,并同时比较各种变应性因素对手术疗效的影响。结果伴有变应性因素的慢性鼻窦炎伴鼻息肉患者,手术疗效为80.95%（136/168）,同期单纯慢性鼻窦炎伴鼻息肉患者,手术疗效为91.75%（189/206）,两组间差异有显著性（P〈0.01）。在各种变应性因素中,伴有变应性鼻炎症状和体征、嗜酸粒细胞阳性、变应原皮肤试验阳性、血清特异性IgE、过敏性鼻炎的慢性鼻窦炎伴鼻息肉患者,与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较,差异均有显著性（P〈0.05）,伴有过敏性疾病史及伴支气管哮喘病史患者与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较,差异无显著性（P〉0.05）。结论变应性因素与鼻窦内窥镜手术疗效密切相关,是术后复发的重要因素。对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术时,必须加强围手术期抗变应性治疗。     

皮肤点刺试验对变应性鼻炎变应原诊断的价值分析

目的探讨皮肤点刺试验对变应性鼻炎变应原诊断的临床价值。方法对临床诊断为变应性鼻炎患者,采用阿罗格点捌试液进行皮肤点刺试验。结果340例变应性鼻炎患者,皮肤点刺试验阳性267例,总阳性率78．53％,其中儿童组105例阳性93例．阳性率88．57％,成人组235例,阳性174例,阳性率74．04％,2组χ^2检验,差异具有统计学意义（P〈0．005）。尘螨变应原阳性率为71．03％,其它变应原阳性率为4．66％,经χ^2检验．差异具有统计学意义（P〈0．005）。结论变应性鼻炎,通常是由变应原致病,尘螨是首要的变应原,皮肤点刺试验对变应性鼻炎变应原诊断具有重要意义,对干预防和指导治疗均具有很重要的临床价值。     

包头地区498例变应性鼻炎变应原筛查与分析

目的了解包头地区变应性鼻炎常见变应原的分布情况。方法以经过变应原皮肤点刺实验确诊为变应性鼻炎的498例患者为研究对象,进行变应原种类分析。结果498例变应性鼻炎患者中,艾蒿占69．3％,藜占57．7％,蒲公英占42．3％,大豚草占42．3％,螨虫占25．6％,其中粉尘螨占13．9％,屋尘螨占11．7％。498例患者中以艾蒿阳性率最高（69．3％）。结论包头地区变应性鼻炎患者常见变应原以艾蒿、大豚草为主,与南方各省市筛查的变应原以螨虫为主有显著差异。故应做好我市的变应原检测工作及防治工作,对本地区变应性鼻炎的免疫治疗有指导意义。     

变应性鼻炎鼻部及鼻外症状学分析

变应性鼻炎是特应性个体接触变应原后引发的由IgE介导的炎性介质的释放和多种免疫活性细胞、细胞因子等参与的鼻黏膜非感染性炎性反应性疾病,其全球性发病率呈逐年增加趋势,与支气管哮喘、鼻窦炎、鼻息肉病和结膜炎等疾病密切相关。鼻部症状是变应性鼻炎的典型症状,除此之外还易伴发眼部症状及胸部症状〔1〕。本研究对2009-06-2010-05期间在我科就诊,临床诊断为变应性鼻炎,行吸入性的皮肤标准化变应原点刺试验至少有1种变应原皮肤点刺结果阳性的187例患者的症状学及变应原皮肤点刺结果进行分析,旨在发现变应性鼻炎鼻外症状的变应原分布及鼻部症状与眼部和胸部症状严重程度的相关性。     

165例慢性鼻-鼻窦炎患者变应性相关临床资料分析

目的 探讨变应性因素在慢性鼻-鼻窦炎伴或不伴鼻息肉患者中的分布特点及其临床意义.方法 随机选取慢性鼻-鼻窦炎( CRS)患者165例,其中伴息肉组(CRSwNP) 98例及不伴息肉组(CRSsNP) 67例,均应用阿罗格体内诊断试剂,进行常规变应原点刺检测(SPT),探讨CRS组内变应原阳性率及其分布特点,且与同期门诊以变应性鼻炎(AR)症状来诊的患者的变应原阳性率及其分布的差别进行比较;并统计CRSwNP的鼻息肉病理切片中嗜酸性细胞浸润程度与变应原检查结果,变应性因素史及既往手术史的相关性.结果 ①发现本组165例CRS患者变应原SPT阳性率为47.3％;CRSwNP组阳性率为50.0％,高于CRSsNP组阳性率,差异没有显著性(P=0.49);但二者均低于AR症状患者(86.8％),差异有显著性(P＜0.0l);②阳性变应原种类及分布特点:CRS患者变应原阳性者中多为混合变应原致敏,单一变应原致敏者较少;主要为吸入组变应原,其中最多见的是常年性变应原粉尘螨和屋尘螨;吸入组变应原分布CRS组内及与AR患者组间无差异(P＞0.05);③CRSwNP患者鼻息肉组织病理切片显示有嗜酸性细胞浸润明显增多的占51.0％;随着嗜酸性粒细胞浸润程度的增加患者人群中变应原阳性及变应性因素史阳性的比例有增加趋势(P＜0.01),但与既往手术史无相关性(P =0.872).结论 变应性因素是促进CRSwNP或CRSsNP疾病发生发展因素之一,对患病人群中变应性因素的必要检测可增加对疾病转归的可控性,具有重要临床意义.     

山东省变应性鼻炎患者变应原皮肤点刺试验结果分析

目的 了解山东省变应性鼻炎患者常见的变应原种类并分析其流行病学资料,为本地区变应性鼻炎防治提供依据。方法 应用阿罗格30种变应原皮试液,对2218例具有典型变应性鼻炎症状患者行皮肤点刺试验,以测定其致敏的变应原。结果 1619例(73%)实验结果为阳性,其中粉尘螨阳性率最高(1164例,71.9%),其次是户尘螨(1125例,69.5%),单一变应原阳性486例,2种及以上变应原阳性的患者有1133例,以吸入性变应原为主。结论 粉尘螨和户尘螨是山东地区变应性鼻炎患者常见的变应原,其次是花粉和霉菌。     

新疆昌吉地区1564例变应性鼻炎患者变应原分布分析

目的:了解新疆昌吉地区变应性鼻炎患者变应原分布状况.方法:选用17种变应原点刺液对1564例变应性鼻炎患者进行皮肤点刺试验.结果:变应原皮肤点刺试验阳性反应1332例,阳性率为85.2％.检出的主要变应原以黎属、啤酒花的阳性率最高,其次是树木花粉.尘螨、真菌及动物毛引起的变应性鼻炎较少.结论:昌吉地区变应性鼻炎的主要变...     

武汉城区柳杉花粉症发病的初步研究

目的：调查武汉城区柳杉花粉症的发病情况。方法：采用问卷调查、鼻腔检查和变应原皮肤试验等方法对湖北医科大学３０９例医学生进行柳杉花粉症的有关调查;并用皮肤划痕试验及鼻粘膜激发试验对２０５例变应性鼻炎患者行柳杉花粉症的临床调查。结果：①３０９例医学生中柳杉花粉变应原皮试阳性２４例（７．８％）;②２０５例变应性鼻炎患者中柳杉花粉变应原皮试阳性５９例（２８．８％）。结论：柳杉花粉症在武汉城区是一种常见的花     

Study of allergic fungal sinusitis in 40 surgical cases of chronic paranasal sinusitis

Allergic fungal sinusitis is chronic and paranasal, related to fungal allergy. Many papers on allergic fungal sinusitis have been reported in the United State, and the incidence is 5% to 10% among patients with chronic paranasal sinusitis. Although cases of allergic fungal sinusitis have been reported in Japan, the incidence is unclear. We studied allergic fungal sinusitis in 40 consecutive patients--26 men and 14 women--undergoing endoscopic sinus surgery at Keiyukai Sapporo Hospital December 2000 to July 2001. We checked for allergic rhinitis and asthma, a history of surgery for nasal polyps and chronic sinusitis, the presence of nasal polyps, grading of sinusitis via computed tomography, nonspecific IgE and allergen-specific IgE for fungi in serum, eosinophilia in nasal smears, paranasal eosinophilic mucin, and histology and fungal culture of paranasal sinus mucus. None had typical allergic fungal sinusitis, but 1 had eosinophilic paranasal mucin, high IgE, and false-positive IgE for fungi. We studied clinical data and histology of fungi and paranasal mucosa in 9 cases with fungal maxillary sinusitis, but none had allergy or eosinophilic mucin. This suggested that few patients with allergic fungal sinusitis exist among those with chronic paranasal sinusitis.     

变应性因素及变应性鼻炎与慢性鼻-鼻窦炎鼻息肉的相关性探讨

目的：探讨变应性因素及变应性鼻炎（AR）与慢性鼻-鼻窦炎鼻息肉的临床相关性。方法：将200例研究对象分为A、B组,A组诊断为AR（110例）,B组诊断为慢性鼻-鼻窦炎鼻息肉（90例）,通过欧蒙印迹法定量检测血清sIgE浓度并观察慢性鼻-鼻窦炎鼻息肉手术治疗后的复发率、AR并发慢性鼻-鼻窦炎鼻息肉的发生率。结果：A组sIgE总阳性率为89.09%,B组sIgE总阳性率为74.44%。B组中sIgE阳性者术后复发率为58.21%,sIgE阴性者术后复发率为8.70%。A组41例（37.27%）并发慢性鼻-鼻窦炎鼻息肉,血清sIgE阳性率为97.56%;69例（62.73%）未并发慢性鼻-鼻窦炎鼻息肉,血清sIgE阳性率为79.71%;组内slgE阳性率比较差异有统计学意义（χ2=6.96,P〈0.01）。结论：变应性因素及AR与慢性鼻-鼻窦炎鼻息肉的发生有一定的相关性,提示避免接触变应原、合理治疗AR能够有效控制慢性鼻-鼻窦炎鼻息肉的复发率。     

Persistent allergic rhinitis includes different pathophysiologic types

BACKGROUND: Allergy rhinitis is typically classified as seasonal allergy rhinitis (SAR) and perennial allergy rhinitis (PAR). More recently, the Allergic Rhinitis and its Impact on Asthma document proposed the intermittent (ITR) and persistent forms (PER). However, it has been previously reported that each single allergen may induce different clinical and pathophysiologic features. OBJECTIVE: The aim of the study was to test the hypothesis that the type of causal allergen might characterize pathophysiologic differences in a cohort of patients with PER. METHODS: Three hundred nineteen patients, sailors of the Italian Navy, with moderate-severe PER were prospectively and consecutively evaluated with clinical evaluation, skin prick test, rhinomanometry, and nasal decongestion test. RESULTS: Patients with pollen allergy showed significantly more severe symptoms, lower nasal airflow, and higher response to decongestion test than patients with allergy to perennial allergens (P < .0001). CONCLUSION: This study provides evidence that patients with PER may show different pathophysiologic patterns depending on the type of causal allergen.     

鼻内镜下鼻息肉切除术对伴发的变应性鼻炎和哮喘症状的影响

目的了解鼻息肉患者接受鼻窦内窥镜手术后变应性鼻炎、哮喘症状的改变。方法采用回顾性研究的方法,应用量化标准评估75例鼻息肉患者术前和术后的变应性鼻炎、哮喘症状及用药情况。结果鼻窦内窥镜手术后, 鼻息肉患者伴发的变应性鼻炎症状有明显改善,显效率为80.00%,有效率为14.67%,而对伴发的哮喘症状治疗效果不明显。结论鼻窦内窥镜手术后,鼻息肉患者伴发的变应性鼻炎症状有明显改善,变应性鼻炎伴有鼻息肉、鼻窦炎者应尽早手术治疗,对鼻息肉伴有哮喘的患者,要正确评估其预后,采取综合治疗措施。     

Expression of Syk is associated with nasal polyp in patients with allergic rhinitis

OBJECTIVE: Numerous signalings are involved in allergic inflammation. The non-receptor protein tyrosine kinase, Syk, is widely expressed in immune-potentiated cells and plays critical roles in initiating signal transduction in response to the activation of cytokine, chemokine and other types of receptors. It has been hypothesized that Syk expression in allergic nasal mucosa and polyps with allergy is different from non-allergic mucosa, and that changes in Syk expression contribute to the activation of allergic reactions. METHODS: We examined whether the expression of Syk is found in allergic nasal mucosa and polyps. We investigated the expression of Syk in 46 nasal mucosa and polyps (14 samples from patients with allergic rhinitis and 32 samples with non-allergic chronic sinusitis) using an immunohistochemical technique. RESULTS: Allergic polyps had more Syk positive cells than non-allergic polyps. Syk positive cells were determined to mainly be eosinophils. There was no difference in Syk expression in the lamina propria and nasal gland between allergic mucosa and non-allergic mucosa. CONCLUSION: Eosinophils in allergic polyps receive an intracellular signal, although the signal is not able to determine the function in the present state. Syk appears to be a promising target molecule for anti-allergic inflammation in allergic rhinitis.     

标准化屋尘螨疫苗特异性免疫治疗常年性变应性鼻炎的疗效观察

目的:了解标准化屋尘螨疫苗特异性免疫治疗常年性变应性鼻炎的疗效。方法:对38例变应性鼻炎患者用标准化屋尘螨疫苗特异性免疫治疗3年或3年以上,免疫前后进行症状和体征评分。结果:38例中,显效21例,有效7例,无效10例,总有效率达73.68%。结论:标准化屋尘螨疫苗特异性免疫治疗变应性鼻炎疗效明显。     

Therapeutic effect of roxithromycin on chronic sinusitis with nasal -- polyps clinical,computed tomography,and electron microscopy analysis

To evaluate the therapeutic effect of Roxithromycin (RXM), we studied 56 chronic sinusitis patients with nasal polyps using computed tomography (CT) and electron microscopy in addition to conventional clinical assessment. The paranasal sinus of subjects was observed clinically before and after daily administration of RXM at 300 mg for 3 months all underwent allergy testing for possible complications of allergic rhinitis based on subjective symptoms and objective findings. Improvement after RXM treatment was seen in 50.3% based on subjective symptoms and 59.1% based on objective findings. Overall improvement was seen in 53.6%. In 41 cases (73.2%) of all patients with chronic sinusitis and complications of allergic rhinitis, no significant difference was seen between patients with and without complications (53.7% in those with complications and 53.3% in those without). In CT analysis the paranasal sinus in 51.8% of all posttreated patients showed obvious improvement. In electron microscopy in chronic sinusitis patients with complications of allergic rhinitis, pretreated ethmoidal sinus tissues showed high mucous epithelial cell apoptosis in addition to common histological lesions, while posttreatment patients showed only eosinophil apoptosis in the interstitium and no apoptotic epithelial cells. We divided ethmoidal sinus lesions in patients without complications into 3 types and evaluated them as follows: In type 1, pretreated ethmoidal sinus tissues showed plasma cell infiltration and posttreatment cell apoptosis. In type 2, pretreated tissues showed lymphocyte and plasma cell infiltration and posttreated showed only some lymphocytes and no plasma cells. In type 3, proliferation of fibroblasts, most of which showed apoptosis, was seen in addition to apoptotic epithelial cells before treatment, while after treatment, these lesions remained with some apoptotic bodies phagocytosed by macrophages. In type 3 patients relapsed after surgery. Our findings indicate that RXM treatment had a significant therapeutic effect on chronic sinusitis with nasal polyps with and without complications of allergic rhinitis. We clarify the morphological mechanism of therapeutic effect of RXM on each type of ethmoidal sinus lesion divided by light and electron microscopy.     

变应性鼻炎与慢性鼻窦炎的关系

目的:观察常年性变应性鼻炎患者鼻窦炎发生的原因及发生率。方法:回顾性分析57例常年性变应性鼻炎患者的临床资料。结果:18例并发鼻窦炎,发生率为32%;其中17例伴有不同程度不同类型的鼻腔解剖结构异常,包括鼻中隔偏曲、中鼻甲气化、钩突肥大、中鼻甲曲线异常和鼻丘气房过度发育等。39例单纯变应性鼻炎者只有7例伴有鼻腔解剖结构异常。结论:变应性鼻炎并发鼻窦炎的基础可能是鼻腔解剖结构异常,变态反应导致的鼻腔黏膜水肿和鼻腔分泌物性质的改变是鼻窦炎的诱发因素之一。     

影响慢性鼻窦炎鼻息肉患者内镜术后嗅觉改善的因素

目的 :探讨影响慢性鼻窦炎鼻息肉患者内镜术后嗅觉改善的有关因素。方法 :4 4例伴有嗅觉障碍的慢性鼻窦炎鼻息肉患者在内镜手术后半年 ,对其性别、分型分期、病变部位、过敏因素、嗅觉障碍时间、随访等因素进行logistic回归分析。 结果 :分型分期 (病变严重程度 )、过敏、随访等 3个因素对内镜术后嗅觉能否改善有显著影响 (P <0 .0 5 ) ;而性别、病变部位和嗅觉障碍时间则无明显影响 (P >0 .0 5 )。结论 :为了使慢性鼻窦炎鼻息肉患者术后嗅觉功能尽可能地恢复 ,在内镜手术彻底清除病变的基础上 ,积极治疗变应性鼻炎和定期随访是十分重要的