Prolonged allergen challenge in murine nasal allergic rhinitis: nasal airway remodeling and adaptation of nasal airway responsiveness

BACKGROUND: Nasal airway remodeling exists in allergic rhinitis, but it appears to be far less extensive than in asthma. However, there has been little study about nasal airway remodeling and no study using mice models. It has been reported that airway hyperresponsiveness decreased after prolonged allergen challenge in a chronic murine asthma model together with the progression of remodeling. However, there has been no study of the relation of remodeling and airway responsiveness in nasal allergy. Therefore, we have undertaken this investigation to characterize nasal airway structural changes after prolonged allergen challenge and to examine the relationship between nasal airway hyperresponsivity and remodeling. METHODS: We prepared murine allergic rhinitis for ovalbumin. Mice were subsequently challenged three times a week with ovalbumin from day 19 to days 53, 88, and 130. We examined allergen-induced nasal symptoms and objective nasal hyperresponsiveness using the enhanced pause system. Moreover, the pathologic changes were investigated after allergen challenge. RESULTS: The extended allergen challenge protocol caused significant nasal airway remodeling. Specifically, remodeling was characterized by goblet cell hyperplasia and deposition of collagen in the submucosal area. Allergen-induced nasal hyperresponsiveness was first increased but gradually decreased in nasal symptoms and Penh after prolonged allergen challenge. CONCLUSIONS: We have demonstrated that a remodeling of nasal mucosa in a murine allergic rhinitis model prolonged allergen exposure. Moreover, prolonged allergen exposure induced a reduction of nasal hyperresponsiveness together with a progression of nasal remodeling.     

Histamine H1 receptor and reactivity of the nasal mucosa in sensitized guinea pigs.

OBJECTIVE: Nasal Hypersensitivity to histamine is higher in allergic patients than that in normal control, suggesting that affinity and/or density of H1 receptors in nasal mucosa may be increased in patients with allergic rhinitis. The purpose in this study is to examine the correlation between the hyperresponsiveness and number of histamine H1 receptors in guinea pig nasal mucosa. METHODS: Guinea pigs were sensitized by DNP-Ascaris antigen. To block histamine H1 receptors, ketotifen was used and the number of receptors was counted by receptor binding assay technique. These data were compared with nasal airway volume (VOL) assessed by acoustic rhinometry of the same animals to know whether the number of H1 receptors is correlated to the nasal responsiveness to the antigen, or not. Eighty animals were divided into five groups which are composed of nonsensitized and sensitized group pretreated with saline, 0.1, 1.0 and 10 mg/kg of ketotifen, respectively. RESULTS: The number of H1 receptors (Bmax) was significantly increased in sensitized group compared with that in control. It decreased dose dependently by pretreatment of ketotifen. The percent change of VOL showed - 31.1 +/- 4.1% at 10 min and - 42.9 +/- 4.1% at 30 min after antigen challenge in sensitized animals. This was dose dependently inhibited by ketotifen. There was a highly inverse correlation between VOL and Bmax (r = -0.708, P< 0.0001). CONCLUSION: These results suggest that sensitization increases the number of histamine H1 receptor, and that increased number of H1 receptor in nasal mucosa in sensitized guinea pigs may be one of the causes of nasal hyperresponsiveness to antigen.     

Nasal and bronchial histamine responsiveness in pollen-exposed patients with seasonal rhinitis

In a previous study, we found an increased nasal responsiveness as measured by rhinostereometry and histamine challenge out of season in a sample of 12 patients suffering mainly from hay fever. The aim of the present study was to investigate whether airway responsiveness in these patients was further increased after direct pollen exposure, after a single nasal pollen provocation as well as by repeated exposure during the pollen season. In spite of increased allergic symptoms, the basal degree of nasal mucosal swelling was unchanged before histamine challenge under these circumstances. After histamine challenge, nasal mucosal swelling was increased in the same way over the seasons. Also bronchial responsiveness was unchanged during the pollen season. It correlated to frequent sneezing following nasal histamine challenge during the season (p = 0.0071, r = -0.74). We interpret the results as an indication of a continuos airway inflammation regardless of season in these patients with pollen allergy, with acute symptoms added on direct exposure to the allergen.     

Allergic rhinitis augments the response to a bacterial sinus infection in mice: A review of an animal model

BACKGROUND: Sinusitis is a poorly understood disease. Despite the significant morbidity and the enormous cost of treating sinusitis, little progress has been made at improving our understanding of its pathophysiology. One reason for restricted progress in understanding the disease is the lack of a satisfactory animal model that mimics sinusitis in man. OBJECTIVE: We review data establishing the development of sinusitis in mice after instillation of Streptococcus pneumoniae, the most common pathogen responsible for acute sinusitis in man. We also review data showing that allergic inflammation in mice worsens a subsequent bacterial sinusitis. We use this data to hypothesize how allergic inflammation worsens a bacterial sinus infection. METHODS: Different strains of mice were made allergic and/or infected. RESULTS: We show our ability to generate an allergic reaction in the nose after sensitization to ovalbumin. Our data further show that an ongoing allergic nasal reaction worsens acute sinusitis. CONCLUSION: A mouse model has been created for a study of the interaction of allergic rhinitis and acute bacterial sinusitis.     

Effects of benzalkonium chloride on innate immunity physiology of the human nasal mucosa in vivo

OBJECTIVE: Benzalkonium chloride (BC) is a preservative commonly used in nasal decongestant sprays. It has been suggested that BC may be harmful to the nasal mucosa. The present study, involving healthy volunteers, examines effects of BC on nasal mucosal end-organ functions. METHODS: Isotonic saline and BC (0.1 mg/mL) were administered acutely to the nasal mucosa using a nasal pool device. Nasal symptoms were determined. Nasal lavage fluid levels of alpha2-macroglobulin and fucose were measured as indices of plasma exudation and glandular secretion, respectively. In addition, BC (0.1 mg/mL) was given as single actuations of 100 microL per nasal cavity three times daily for 10 days. The ability of histamine (0.4 mg/mL) to evoke nasal symptoms and plasma exudation responses was determined before and after the repeated BC administration series. RESULTS: BC produced immediate nasal smart or pain (P < .05), but tolerance to this response developed by repeated administrations. BC increased nasal mucosal output of fucose (P < .05), whereas nasal lavage fluid levels of alpha2-macroglobulin were unaffected. Histamine produced significant symptoms and mucosal exudation of alpha2-macroglobulin (P values < .01), equally before and after the 10 days of BC exposure. CONCLUSIONS: BC in dosages commonly used as preservative in nasal decongestant sprays produced short-term glandular secretion and nasal smart or pain. However, 10 days' frequent exposure to BC was not associated with untoward symptomatic effects, nor was a sensitive mucosal variable such as histamine-induced exudative responsiveness affected by this repeated exposure 1 BC.     

鼻腔冲洗在儿童鼻炎及鼻窦炎治疗中的应用发展

儿童鼻-鼻窦炎在儿科是一种常见疾病,有其自身特点,除进行药物治疗,同时鼻腔冲洗也是一种保持鼻腔清洁、减轻鼻黏膜炎症反应的有效方法,可以广泛应用于各种儿童鼻腔、鼻窦炎性疾病,包括急性和慢性鼻窦炎、变应性及非变应性鼻炎、非特定性鼻腔症状等。儿童鼻腔冲洗液的选择、鼻冲洗装置的选择有其区别于成人的特点。由于该方法临床运用有效,操作简便,是一种为儿童易于接受的治疗方法,具有良好的安全性和耐受性。本文就鼻腔冲洗在儿童鼻炎及鼻-鼻窦炎治疗中的应用发展做一综述。     

Nasal interleukin-5, immunoglobulin E, eosinophilic cationic protein, and soluble intercellular adhesion molecule-1 in chronic sinusitis, allergic rhinitis, and nasal polyposis

OBJECTIVE: To compare concentrations of interleukin-5 (IL-5), immunoglobulin E (IgE), eosinophilic cationic protein (ECP), and soluble intercellular adhesion molecule-1 (sICAM-1) in nasal secretion and serum of patients with chronic nonallergic sinusitis, allergic rhinitis, and nonallergic nasal polyposis to obtain information about the pathogenesis of these diseases. METHODS: Nasal secretion and serum were analyzed by routine enzyme-linked immunosorbent assay techniques. Nineteen patients with chronic nonallergic sinusitis, 24 patients with seasonal allergic rhinitis, and 18 patients with nonallergic nasal polyposis were included in the study. Eight healthy, nonallergic probands served as control subjects. RESULTS: Significantly elevated concentrations of IL-5 (5-fold, P < .05) and IgE (15-fold, P < .01) were detected in nasal secretion of patients with allergic rhinitis (IL-5, 51.8 +/- 13.2 pg/mL; IgE, 41.9 +/- 20.9 kU/L) or nonallergic nasal polyposis (IL-5, 57.9 +/- 36.9 pg(mL; IgE, 40.5 +/- 20.2 kU/L) compared with controls (IL-5, 10.6 +/- 7.8 pg/mL; IgE, 2.8 +/- 0.5 kU/L) or with patients with chronic nonallergic sinusitis (IL-5, 16.5 +/- 13.2 pg/mL; IgE, 5.4 +/- 3.1 kU/L). There were no significant differences between patients with allergic rhinitis and those with nonallergic nasal polyposis. Concentrations of ECP were significantly elevated (sixfold, P < .01) in patients with allergic rhinitis (297.8 ng/mL +/- 173.1) compared with controls (52.4 +/- 28.0 ng/mL) or patients with chronic nonallergic sinusitis (44.8 +/- 40.1 ng/mL), whereas twofold higher concentrations (not significant) of ECP were observed in patients with nonallergic nasal polyposis (107.1 +/- 26.6 ng/mL). Significantly elevated concentrations of sICAM-1 in nasal secretion (threefold, P < .05) were detected only in patients with chronic nonallergic sinusitis (79.4 +/- 45.6 ng/mL). The elevated sICAM-1 nasal secretion values in this group correlated significantly (P < .05) to the serum values. CONCLUSIONS: Equally elevated concentrations of IL-5 and IgE in patients with allergic rhinitis and nonallergic nasal polyposis implicated similar pathogenic processes in both diseases. Whereas the pathogenesis of allergic rhinitis is IgE-specific, the pathogenesis of nasal polyps is not as clear. IL-5 was suggested to play a pivotal role in tissue eosinophilia, which was confirmed by data in the present study. Elevated concentrations of ECP were suggested to result from tissue eosinophilia--a characteristic of both diseases. Elevated concentrations of sICAM-1 in patients with chronic nonallergic sinusitis pointed to its key role in the recruitment of neutrophils into the inflamed tissue, whereas an important role in eosinophil recruitment was ruled out.     

Hyperresponsiveness of congestive nasal reflexes in allergic rhinitis

BACKGROUND: Nasal secretory hyperresponsiveness is well documented in allergic rhinitis, and is mediated in part by neural mechanisms. In contrast, reflex-mediated congestion is poorly documented in both normal and allergic subjects. OBJECTIVE: To characterize congestive responses to unilateral nasal bradykinin challenge in normal and allergic subjects, and to investigate whether congestive hyperresponsiveness is present in allergic rhinitis. METHODS: Normal subjects (n = 13), and subjects with out-of-season seasonal allergic rhinitis (SAR) (n = 16) underwent a unilateral nasal challenge protocol using filter paper disks, using Hartman's solution and bradykinin as challenge substances. Congestive responses were measured using acoustic rhinometry. RESULTS: Normal subjects demonstrated a transient ipsilateral congestive response, and a circumscribed contralateral congestive response away from the major flow limiting section. Subjects with SAR demonstrated a more persistent ipsilateral congestive response, and a more pronounced, generalized contralateral congestive response affecting all areas of the contralateral nasal cavity. Significant differences were present between normal and SAR subjects. CONCLUSION: Congestive reflexes are present in normal and allergic subjects. Congestive hyperresponsiveness is present in allergic rhinitis.     

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。     

Nasal cytology in the diagnosis and treatment of sinusitis in atopic and nonatopic children

OBJECTIVES: To investigate the value of nasal cytology in the diagnosis of sinusitis and follow-up of atopic and nonatopic children before and after treatment and to compare the nasal cytologic findings with the radiologic findings. DESIGN: Open randomized investigation. SETTING: Ministry of Health, Ankara Diskapi Children's Hospital. METHOD: Fifty-five children with bronchial asthma and/or allergic rhinitis followed by the Allergy Department of the Ministry of Health, Ankara Diskapi Children's Education and Research Hospital and 35 control children were evaluated for the following parameters: symptoms and signs of sinusitis, total serum immunoglobulin E level and eosinophil count, skinprick tests to common allergens, paranasal sinus radiographs, and nasal cytology (by the Rhinoprobe [Synbiotics Inc. London] method and wax paper blow). MAIN OUTCOME MEASURES: Nasal cytology, radiologic findings, and treatment. RESULTS: There were no significant correlations between radiologic and cytologic findings in any of the groups (p > .05). In both atopic and nonatopic chronic sinusitis patients, the Rhinoprobe method had results similar to the radiologic findings, and there was a significant relationship (p < .05). CONCLUSIONS: Nasal cytology is still a diagnostic tool in the follow-up and evaluation of chronic sinusitis in atopic children but should not be considered an adequate alternative to sinus radiography.     

The correlation between bacteriological findings in the nose and maxillary sinus in acute maxillary sinusitis

Nasal and sinus bacteriology have been investigated in healthy controls and in patients with acute maxillary sinusitis. Comparatively few healthy noses were sterile, and in controls the nasal bacterial flora commonly consisted mainly of staphylococci and diphtheroid rods. Nasal specimens from patients with sinusitis showed most common findings to be “no growth,” pneumococci, Haemophilus influenzae and staphylococci in that order. In aspirated sinus secretions there was a predominance of pneumococci, “no growth” and Haemophilus influenzae. Other bacteria were uncommon. Staphylococci were shown conclusively to be nasal contaminants. The same organisms were found in the nasal and sinus secretions of patients with sinusitis in only 64 percent, thus indicating that nasal samples are of low predictive value in reflecting sinus flora. It can be argued that in the individual patient with sinusitis it is more reliable to base therapy on the results of previous bacteriological investigations than on the individual bacteral findings in the nose.     

Effect of genetic background on the response to bacterial sinusitis in mice

OBJECTIVE: To study the importance of ongoing allergen exposure and TH1/TH2 genetic background in augmented bacterial and inflammatory responses in allergic and infected mice. DESIGN: BALB/c and C57BL/6 mice were made allergic to ovalbumin. After 1 day of intranasal allergen exposure, they were inoculated intranasally with Streptococcus pneumoniae. The numbers of bacteria and inflammatory cells in the sinuses were determined, and nasal responsiveness to histamine was assessed. RESULTS: Infected BALB/c and C57BL/6 mice that received ongoing ovalbumin challenge following intraperitoneal sensitization showed significantly greater bacterial load and phagocyte level compared with the infected-only mice. Differences were diminished after the allergen challenge was stopped. Allergic and infected C57BL/6 mice showed fewer bacteria and phagocytes compared with the allergic and infected BALB/c mice. Surprisingly, in contrast to the nonallergenic C57BL/6 mice, the infected BALB/c mice showed a larger number of bacteria 28 days after infection. CONCLUSIONS: Ongoing allergic reaction augments bacterial load in both BALB/c and C57BL/6 mice and induces nasal hyperreactivity to histamine. Allergic and infected C57BL/6 mice show less allergic inflammation and bacterial load compared with allergic and infected BALB/c mice. Stopping allergen exposure reduces the response. Infected BALB/c mice, which favor a TH2 response, were less able to clear infection than C57BL/6 mice, which favor a TH1 response. Inflammation and bacterial load are affected by genetic background of mice and ongoing allergen stimulation.     

Different swelling mechanisms in nasal septum (Kiesselbach area) and inferior turbinate responses to histamine: an optical rhinometric study

OBJECTIVE: To determine whether the inferior turbinate, which contains swelling bodies, and the nasal septum (Kiesselbach area), characterized by a dense arterial mesh, exhibit different swelling mechanisms in allergic nasal reactions. DESIGN: Two optical rhinometers were used to examine 11 patients in the clinic. Optical rhinometry is based on the transillumination of the nasal septum and inferior turbinate or the whole nose with monochromatic light. The instrument's wavelength can be adjusted to the absorption characteristics of reduced hemoglobin, oxygen-saturated hemoglobin, and water. SETTING: Outpatient university otolaryngology clinic. PATIENTS: Eleven young, healthy, nonsmoking, nonpregnant subjects (6 men and 5 women), mean age, 32.4 years (age range, 27-37 years), with no history of exposure to toxic substances, allergies, or other significant diseases. INTERVENTIONS: Optic rhinometry evaluation during the course of nasal histamine administration. MAIN OUTCOME MEASURES: Light extinction at various wavelengths. RESULTS: Following administration of histamine, in the nasal septum, the wavelength of 950 nm (edema) showed the strongest increase of light extinction; in the inferior turbinate, it was the wavelength of 786 nm (oxygenated hemoglobin). In the whole nose, the wavelength of 880 nm (edema plus hemoglobin) exhibited the largest increase of extinction. CONCLUSIONS: Swelling of the nasal septum (Kiesselbach area) in nasal allergic reactions is caused mainly by edema, whereas swelling of the inferior turbinate is due mainly to an increase in volume of blood that is highly saturated with oxygen. Swelling of the whole nose is characterized by the combination of both, edema and increase in blood volume.     

组胺H4受体及其拮抗剂对变应性鼻炎大鼠的作用研究

目的 通过变应性鼻炎(allergic rhinitis,AR)动物模型,观察组胺H4受体拮抗剂JNJ 7777120对AR大鼠的影响.方法 60只Wistar大鼠以随机数字表法分为5组,每组12只,分别为:正常对照(NC)组、AR模型未处理(AR)组、组胺H1受体拮抗剂氯雷他定处理(HR1)组、组胺H4受体拮抗剂JNJ 7777120处理(HR4)组及组胺H1、H4受体拮抗剂联合处理(HR1+4)组.以卵清蛋白建立大鼠AR模型,比较各组大鼠喷嚏、抓鼻次数、血清总IgE、白细胞介素(interleukin,IL)4、γ干扰素(interferon-γ,IFN-γ)以及及鼻腔灌洗液中趋化因子Eotaxin含量的差异.采用SPSS 13.0软件对数据进行分析.结果 各干预(HR1、HR4、HR1+4)组与AR组相比喷嚏、抓鼻次数、血清总IgE、IL-4、趋化因子Eotaxin含量均显著下降,而IFN-γ显著升高,差异有统计学意义(P值均0.05).HR4组大鼠平均((x)±s,下同)喷嚏、抓鼻次数、血清总IgE、IL-4分别为(29.3±6.5)次、(28.4±7.0)次、(147.67±28.79)mg/ml、(289.05±16.94)Pg/ml,较HR1组的(23.2±5.6)次、(21.4±5.2)次、(100.32±6.00)mg/ml、(267.71±24.26)Pg/ml升高,差异有统计学意义(q值分别为3.72、4.16、8.01、4.96,P值均<0.05),而INF-γ水平在HR4组为(28.17±1.97)pg/ml,低于HRI组的(35.45±1.35)pg/ml,差异有统计学意义(q=3.18,P<0.05).各干预组(HR1、HR4、HRI+4)中Eotaxin含量差异无统计学意义(P=0.096).结论 组胺H4受体拮抗剂JNJ 777120与组胺H1受体拮抗剂氯雷他定同样可以缓解AR症状及炎性反应状态,两者之间未发现有协同作用,JNJ 7777120与氯雷他定相比作用相对较弱.     

Persistent inflammation and hyperresponsiveness following viral rhinosinusitis

OBJECTIVES: To develop a murine model of viral rhinosinusitis. STUDY DESIGN: Randomized, controlled, animal model. METHODS: Mice were intranasally inoculated with Sendai virus (SeV) or ultraviolet (UV)-inactivated virus. On days 3 and 10 postinfection, nasal lavage fluid was obtained for viral culture. On days 4, 10, and 38 postinfection, sinus mucosa was harvested and analyzed by flow cytometry for CD3-, CD4-, CD8-, CD25-, CD11b-, CCR3-, and GR1-positive cells. Nasal hyperresponsiveness to histamine challenge was measured on days 8 and 36 postinoculation. RESULTS: On day 3, viral cultures were positive from all SeV-inoculated mice but from none of the UV-inactivated mice (P相似文献   

Swine dust exposure is a model for rapid induction of non-allergic neutrophil inflammation in the nasal mucosa of healthy volunteers, and the symptoms as well as the microcirculation are modified by nasal lavage

BACKGROUND: The pathophysiological mechanism of non-allergic rhinitis is not clear and there is a lack of models in healthy volunteers. It has previously been shown that swine dust exposure is an excellent method for inducing inflammatory changes in the lower airways. We have shown earlier that exposure to swine dust increases the histamine sensitivity of the nasal mucosa as measured by rhinostereometry. In this study the aim was to investigate the effects of swine dust exposure on nasal symptoms as well as the microcirculation. Furthermore, the effect on nasal lavage was investigated. METHOD: Seventeen subjects were exposed to swine dust during a three-hour period of work in a swine house. Nasal symptoms and the nasal mucosal response to histamine before and after exposure to swine dust were evaluated by laser Doppler flowmetry and nasal lavage. RESULTS: Exposure to swine dust increased nasal symptoms and levels of neutrophils, IL-8 and albumin. The increase in nasal symptoms and the microcirculation were modified by nasal lavage. CMBC correlated inversely with an increase in albumin (p = 0.018, R = -0.95). Conclusions: Swine dust exposure is a useful model for inducing nasal inflammation in healthy volunteers. Furthermore, nasal lavage modifies subjective as well as objective parameters, which should be considered when designing studies. Nasal lavage may be useful in the treatment of workers in a swine dust environment.     

Signals through CD40 play a critical role in the pathophysiology of Schistosoma mansoni egg antigen--induced allergic rhinitis in mice

BACKGROUND: Interaction between CD40 and CD40L is thought to regulate immune responses in several allergic diseases. However, little is known about its in vivo role in the pathophysiology of allergic rhinitis. We sought to determine whether the lack of signals through CD40 affects the pathophysiology of allergic rhinitis using a murine model. METHODS: Wild type (WT) and CD40-deficient BALB/c (CD40-/-) mice were sensitized intranasally to Schistosoma mansoni egg antigen (SEA). After repeated sensitization, histamine responsiveness, serum antibody titer including immunoglobulin E (IgE), nasal eosinophilia, and cytokine production by nasal mononuclear cells were determined in each group. RESULTS: Intranasal sensitization with SEA in WT mice elicited a strong Th2 response including SEA-specific IgE production, nasal eosinophilia, and interleukin (IL)-4, and IL-5 production by nasal mononuclear cells after antigen challenge. Production of SEA-specific IgE and IgG1 was abolished in SEA-sensitized CD40-/- mice. These mice showed impaired nasal eosinophilia and displayed markedly reduced histamine-induced nasal hyperresponsiveness as compared with WT mice. Furthermore, reduced production of IL-4 and IL-5 by nasal mononuclear cells was seen in CD40-/- mice. CONCLUSION: These results show that signals through CD40 play a critical role in not only IgE production but also pathophysiology of allergic rhinitis such as nasal hyperresponsiveness and nasal eosinophilia.     

Predictive value of nasal bacterial culture for etiological agents in acute maxillary sinusitis

Nasal secretion, aspiration yield and lavage content from the sinus were studied for bacteria in 175 patients (247 sinuses) with acute maxillary sinusitis. The same pathogen was cultured from the nose and aspiration fluid in 91% of cases of acute purulent sinusitis. This indicated a significant predictive value of the nasal bacteriological culture for presence of pathogenic bacteria in the sinus in purulent cases. In cases with no growth of pathogens in the aspirate, the nasal culture showed pathogenic bacteria in about 50%. Examination of the aspiration fluid may occasionally give false negative result in purulent maxillary sinusitis (at least 3% in the present series). In these cases, culture of the irrigation yield may prove helpful.     

丙酸氟替卡松鼻喷雾剂联合通窍鼻炎片治疗变应性鼻炎的临床观察

目的观察采用丙酸氟替卡松鼻喷雾剂联合通窍鼻炎片治疗变应性鼻炎的临床效果。方法随机从2018年01月~2019年12月接受变应性鼻炎治疗的患者中选取出100例,按照应用不同的治疗方法,分为每组各50例的观察组和对照组,观察组患者用丙酸氟替卡松鼻喷雾剂联合通窍鼻炎片治疗,对照组患者单用丙酸氟替卡松鼻喷雾剂治疗,观察两组患者的治疗效果,以鼻痒、鼻塞、打喷嚏、流鼻涕等症状的缓解作为治疗效果的评价依据。结果观察组患者的总有效率是94.0%,对照组患者的总有效率是78.0%,观察组总有效率明显优于对照组,两组差异有统计学意义(P<0.05)。观察组患者的鼻痒、鼻塞、打喷嚏、流鼻涕等症状缓解明显早于对照组,两组差异有统计学意义(P<0.05)。结论丙酸氟替卡松鼻喷雾剂联合通窍鼻炎片治疗变应性鼻炎,可有效缓解鼻痒、鼻塞、打喷嚏、流鼻涕等症状,鼻腔黏膜水肿消退、色泽恢复快,疗效显著,减少了药物的不良反应,提高了用药的安全性。     

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。