Diagnostic significance of nasal eosinophilia in allergic rhinitis

Background  Nasal eosinophilia is one of the potential tests for substantiating the diagnosis of allergic rhinitis. Objective  The aim was to establish the validity of nasal eosinophilia in allergic rhinitis, to study it's various clinical correlates and interpret it in context of skin sensitivity pattern. Study Design  Prospective cased study. Setting  Hospital based. Patients  The patients were selected on the basis of history and clinical examination and were from the Himalayan region. Intervention  Diagnostic. Methods  The patients and the equal number of controls, were subjected to nasal smear for eosinophilia and intra-dermal skin tests to various allergeus. Results  Overall, eighty percent of nasal smears were positive in various degrees among the cases. Around eighty-eight percent of cases showed both smear and skin test positivity, thereby signifying a high degree of harmony among them and further validating and confirming the diagnosis of allergic rhinitis. Conclusion  Nasal eosinophilia was found to be a useful diagnostic test in allergic rhinitis, with a moderately high sensitivity and a high specificity.     

鼻内窥镜射频热凝筛前神经治疗变应性鼻炎

探讨提高治疗变应性鼻炎效果的方法,方法：利用息肉窥锏上筛前神经射频治疗变就性鼻炎患者８８例,随访１年,结果,显效７３例,有效１１例,无效４例,总有效率达９５．５％,结论鼻内窥镜下筛前神经射频治疗变应性鼻炎具有疗效显著,操作方便,治疗部位准确等优点,有较好临床应用价值。     

变应性鼻炎鼻黏膜上皮细胞免疫活性研究进展

鼻黏膜上皮细胞构成的物理和化学屏障是呼吸道接触外源性微生物、变应原和环境污染物等的第一道防线。除理化屏障功能,上皮细胞在变应性鼻炎发病机制中的免疫调控作用受到越来越多的重视。上皮细胞对天然免疫和获得性免疫均具有重要的免疫调控功能,这种免疫调控功能的实现依赖于功能性细胞因子的表达及上皮细胞与下游免疫细胞的相互信息传递。现就鼻黏膜上皮细胞与变应原及其他免疫细胞之间的信息传递做一简要梳理。     

鼻内镜下聚焦超声治疗变应性鼻炎疗效观察

目的:观察鼻内镜下聚焦超声治疗变应性鼻炎的疗效。方法:运用CZB型超声波鼻炎治疗仪,在鼻内镜下对117例常年性变应性鼻炎患者进行治疗,治疗部位分别为下鼻甲及鼻中隔前上部。按照2004年兰州会议"变应性鼻炎的治疗原则和推荐方案",用记分法分别评定其疗效。结果:术后随访12个月进行疗效评价,其中显效率37.6%(44/117),有效率41.9%(49/117),无效率20.5%(24/117),总有效率为79.5%(93/117)。结论:鼻内镜下采用聚焦超声治疗变应性鼻炎,具有操作简单、创伤小、可重复性等优点,安全性高,近期效果显著;但远期疗效有待进一步观察研究。     

白细胞介素-12在变应性鼻炎鼻粘膜中的表达

目的 :探讨白细胞介素 12 (IL 12 )在变应性鼻炎鼻粘膜中的表达。方法 :以卵清蛋白为变应原建立豚鼠变应性鼻炎模型 (模型组 )。取该模型和健康豚鼠鼻粘膜行常规HE染色 (对照组 ) ,并采用逆转录 聚合酶链反应 (RT PCR)检测方法 ,对两组动物鼻粘膜组织中IL 12mRNA表达水平进行相对定量比较。结果 :IL 12mR NA在两组鼻粘膜中均有表达 ,模型组的表达水平为 0 .6 6 7± 0 .10 4显著低于正常对照组 0 .84 7± 0 .0 71(P <0 .0 1)。结论 :在变应性鼻炎鼻粘膜组织中IL 12的表达下降 ,提示应用IL 12替代疗法治疗变应性鼻炎的可能性。     

伴或不伴变应性鼻炎的鼻息肉组织中水通道蛋白5的表达及意义

目的:证实水通道蛋白5(AQP5)在鼻息肉组织中的表达及分布。方法:挑选行鼻内镜手术的鼻息肉患者36例,分为变应组16例和非变应组20例。变应组为伴有变应性鼻炎症状患者;非变应组为不存在变应症状患者。取所有患者术后鼻息肉组织,用免疫组织化学技术检测AQP5的表达及分布,并测定阳性细胞的积分吸收度和灰度值。结果:①2组鼻息肉常规苏木精-伊红染色表现为明显的腺体增生、炎症反应和嗜酸粒细胞浸润,但变应组较非变应组更为明显;②免疫组化染色显示AQP5在变应组和非变应组鼻息肉中的分布基本一致,主要表达在腺上皮细胞、导管上皮细胞及纤毛上皮细胞的细胞膜和细胞质中;③对切片的积分吸收度进行统计学分析显示,变应组AQP5在鼻息肉细胞中的量(0.1675±0.006536)明显高于非变应组(0.09343±0.001816),2组间差异有统计学意义(P<0.01)。④对切片的灰度值进行统计学分析显示,变应组AQP5在鼻息肉细胞中的表达(175.6±2.471)明显低于非变应组(206.2±0.965),2组间差异有统计学意义(P<0.01)。结论:AQP5存在于鼻息肉组织中,在伴有变应性症状患者的鼻息肉组织中,AQP5的表达量要比非变应症状患者的鼻息肉中AQP5表达量多,推测与鼻腔分泌物的增多及其性质有关,而不同症状的鼻息肉患者可能存在不同的发病机制。     

鼻腔冲洗在变应性鼻炎治疗中的临床疗效

目的分析变应性鼻炎(AR)患者接受鼻腔冲洗治疗的临床疗效。方法将2019年6月~2020年8月作为研究时间段,选取期间我院接诊的78例AR患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入39例)、研究组(加用鼻腔冲洗治疗,纳入39例),对组间气道反应性、症状消失时间展开分析。结果(1)组间气道反应性指标在治疗前无明显差异,P>0.05;研究组共振频率(Fres)、中心气道阻力(R20)、气道总阻力(R5)在治疗后低于对照组,P<0.05;(2)研究组鼻塞、流涕、喷嚏、鼻痒消失时间均少于对照组,P<0.05。结论鼻腔冲洗对改善AR患者气道反应、临床症状均有明显效果,值得推广。     

The surgical management of allergic rhinitis

In their discussion of the treatment of allergic rhinitis, the authors present key features of the disease and its management, allergen responses, the role of the inferior turbinate, and reviews of outcomes with submucosal resection, total inferior turbinectomy, cryosurgery, laser cautery, radical turbinectomy, submucous turbinectomy, submucous electrocautery, and microdebriber turbinoplasty. The authors discuss radiofrequency ablation and coblation outcomes and complications, along with the role of endoscopic sinus surgery in allergic rhinitis and emphasize the need for Otolaryngologists to be facile with a variety of procedures for best outcomes.     

Nasal sound analysis: a new method for evaluating nasal obstruction in allergic rhinitis

OBJECTIVE: Current measurements of nasal obstruction are unreliable and may be improved with the development of new techniques. The effectiveness of odiosoft-rhino (OR) in the evaluation of nasal obstruction was investigated in a blind comparison at a referral center, institutional practice. PATIENTS: Forty-eight patients with perennial allergic rhinitis and 52 healthy subjects were studied. Nasal endoscopic examination, acoustic rhinometry (AR), and OR were performed and symptom scores compared. MAIN OUTCOME MEASURE: Assessment of nasal blockage with OR method was the main outcome measure. RESULTS: Using the OR technique, significant differences were observed between the patient and control groups. OR data correlated with symptom scores and endoscopic examination. However, this was not observed with AR. A 15.5-dB cutoff point for the left side and 14.5 dB cutoff point for the right side at the 2,000 to 4,000 Hz frequency interval resulted in 93.8% sensitivity and 92.3% specificity and 72.9% sensitivity and 80.8% specificity, respectively. A 8.5-dB cutoff point for the left and right sides at the 4,000 to 6,000 Hz frequency interval resulted in 87.5% sensitivity and 80.8% specificity and 70.8% sensitivity and 78.8% specificity, respectively. CONCLUSION: OR is a simple, noninvasive test for assessing nasal obstruction. The OR technique can detect nasal obstruction with high sensitivity and specificity, and these findings correlate with symptoms and physical examination.     

针刺对变应性鼻炎患者血浆内皮素及鼻粘膜微血管的影响

目的对３３例常年性变应性鼻炎患者进行针刺治疗,以观察其对血浆内皮素（ｅｎｄｏｔｈｅｌｉｎ,ＥＴ）及鼻粘膜微血管的影响。方法①血浆ＥＴ测定：采用特异性放射免疫法（均相竞争法）直接测定血浆ＥＴ含量。②鼻粘膜微血管的观察：主要观察鼻粘膜微血管管径、管袢数及鼻粘膜微血管的形态。③针刺治疗：选择曲池、血海两穴进行针刺。结果变应性鼻炎患者鼻粘膜微血管管径针刺后较针刺前增粗;针刺后变应性鼻炎患者鼻粘膜微血管形态变化以灯丝状微血管增多、网络状微血管减少为特征;变应性鼻炎患者鼻粘膜微血管管袢数针刺后较针刺前增多;变应性鼻炎患者针刺后血浆ＥＴ含量明显降低。结论变应性鼻炎针刺后鼻粘膜微循环明显改善,表现为鼻粘膜微血管管径增粗,灯丝状微血管增多、网络状微血管减少,管拌数增加,并与血浆ＥＴ存在密切关系,其机理可能是通过降低血浆ＥＴ的水平而起作用的。     

鼻息肉伴变应性鼻炎患者白细胞介素水平与鼻息肉复发的关系研究

目的研究鼻息肉伴变应性鼻炎患者白细胞介素水平与鼻息肉复发的关系,进一步阐明其发病机制,为临床防治提供参考。方法选取成都市第二人民医院耳鼻咽喉科行鼻内镜手术治疗的鼻息肉伴变应性鼻炎手术后,根据鼻息肉有无复发,将患者分为未复发组和复发组,未复发组患者20例（A组）,复发组患者20例（B组）,另将鼻中隔偏曲伴下鼻甲肥大患者20例设为对照组。术前、术后1周各组患者均抽取空腹静脉血检测白细胞介素-8（interleukin 8,IL 8）、白细胞介素-16（interleukin 16,IL 16）、白细胞介素-17（interleukin 17,IL 17）水平,鼻息肉切除术中保留息肉头端组织,对照组患者术中取部分下鼻甲黏膜组织,采用免疫组织化学方法（SP法）检测IL 8、IL 16、IL 17表达。采用Pearson多重线性分析IL 8、IL 16、IL 17水平与伴变应性鼻炎的鼻息肉复发患者的相关性。结果术前A、B组血清IL 8、IL 16、IL 17水平均高于对照组,差异具有统计学意义（P＜0.05）。术后A、B组血清IL 8、IL 16、IL 17较术前明显降低,差异具有统计学意义（P＜0.05）。B组术后IL 8、IL 17水平明显高于对照组及A组,差异具有统计学意义（P＜0.05）。术后1周B组鼻息肉组织中IL 8、IL 16、IL 17中、强阳性表达率分别为60.0%、75.0%和80.0%,明显高于A组的45.0%、50.0%和60.0%,差异具有统计学意义（P＜0.05）。A组和B组鼻息肉组织中IL 8、IL 16、IL 17中、强阳性表达率均高于对照组的0.0%、0.0%和0.0%,差异有统计学意义（P＜0.05）。IL 8、IL 16、IL 17与伴变应性鼻炎鼻息肉的发生呈正相关（r=0.716、0.917、0.903,P均=0.000）;与鼻息肉复发呈正相关（r=0.527、0.763、0.842,P=0.014、0.000、0.000）。结论伴变应性鼻炎鼻息肉患者的血清与鼻息肉组织中白细胞介素水平和表达明显升高,息肉组织中白细胞介素高表达与复发呈正相关,提示应采取有效措施消除局部炎症,降低鼻息肉的复发率。     

鼻炎冲剂对变应性鼻炎鼻粘膜的影响

观察鼻炎冲剂对应性鼻炎患者鼻粘膜的影响,证实对ＡＲ的治疗,方法：选用健康豚鼠２９只,随机分成剂组,阳性对照组,阴性对照组和空白对照组,冲剂组采用鼻炎冲剂治疗。结果冲剂组鼻痒,喷嚏计分明显低于其他组。结论鼻炎冲剂可以改善ＡＲ患者鼻粘膜的炎症变状态,从组织学证明其对ＡＲ具有明显的治疗作用。     

Effect of topical corticosteroids on nasal patency after acute positive airway pressure exposure

IntroductionNasal congestion and obstruction are reported in the majority of continuous positive airway pressure users and are frequently cited as reasons for noncompliance. Baseline inflammation due to allergic rhinitis could increase or exacerbate the inflammatory effect of high airflow in the nasal cavity as the result of continuous positive airway pressure and lead to greater continuous positive airway pressure intolerance. In this setting, intranasal steroids would be expected to counteract the nasal inflammation caused by allergic rhinitis and/or continuous positive airway pressure.ObjectiveThe aim of the present study is to evaluate the effects of topical corticosteroid use on nasal patency after acute exposure to positive pressure.MethodsTen individuals with allergic rhinitis were exposed to 1 h of continuous airway pressure (15 cm H₂O) in the nasal cavity, delivered by a continuous positive airway pressure device. Visual analog scale, nasal obstruction symptom evaluation scale, acoustic rhinometry and peak nasal inspiratory flow were performed before and after the intervention. After 4 weeks topical nasal steroid (budesonide) application, positive pressure exposure was repeated as well as the first assessments.ResultsPatients reported a statistically significant improvement both on the visual analog (p = 0.013) and obstruction symptom evaluation scales (p < 0.01). Furthermore, objective measurements were improved as well, with increased nasal cavity volume on acoustic rhinometry (p = 0.02) and increased peak nasal inspiratory flow (p = 0.012), after corticosteroid treatment.ConclusionIn patients with allergic rhinitis, intranasal corticosteroid therapy improved objective and subjective parameters of nasal patency after acute exposure of the nasal cavity to positive pressure.     

鼻腔盐水冲洗和局部应用激素对变应性鼻炎的治疗价值

目的：通过研究鼻腔局部冲洗和应用激素对变应性鼻炎的影响,探讨治疗变应性鼻炎的恰当方式。方法临床方面采用视觉模拟评分量表（VAS）和迷你型鼻结膜炎生活质量问卷（MiniRQLQ）评估健康对照组及各实验组临床症状的改变,实验室方面采用瑞典Pharmacia UniCAP 100型免疫荧光定量分析系统检测健康对照组及各实验组血清中屋尘螨特异性IgE（sIgE）和嗜酸性粒细胞阳离子蛋白（ECP）的含量的改变。结果单纯鼻腔冲洗组（A组）和局部激素溶液冲洗组（D组）无论是临床方面还是实验室方面评估都没有显著性改变,而单纯鼻喷激素组（B组）和鼻喷激素联合冲洗组（C组）两方面均有统计学差异,并且后两组间比较无显著性差异。结论单纯鼻喷激素或鼻喷激素联合冲洗是治疗变应性鼻炎的恰当方式,单纯鼻腔冲洗或局部激素溶液冲洗在治疗变应性鼻炎方面只能作为辅助手段。     

The effects of spirulina on allergic rhinitis

The prevalence of allergic rhinitis is increasing globally due to various causes. It affects the quality life of a large group of people in all around the world. Allergic rhinitis still remains inadequately controlled with present medical means. The need of continuous medical therapy makes individuals anxious about the side effects of the drugs. So there is a need for an alternative strategy. Effects of spirulina, tinospora cordifolia and butterbur were investigated recently on allergic rhinitis in just very few investigations. Spirulina represents a blue-green alga that is produced and commercialized as a dietary supplement for modulating immune functions, as well as ameliorating a variety of diseases. This double blind, placebo controlled study, evaluated the effectiveness and tolerability of spirulina for treating patients with allergic rhinitis. Spirulina consumption significantly improved the symptoms and physical findings compared with placebo (P < 0.001***) including nasal discharge, sneezing, nasal congestion and itching. Spirulina is clinically effective on allergic rhinitis when compared with placebo. Further studies should be performed in order to clarify the mechanism of this effect.     

变应性鼻炎患者血清与鼻分泌物中粉尘螨sIgE的相关性研究

目的 :探讨常年性变应性鼻炎患者血清与鼻分泌物中粉尘螨 s Ig E( specific Ig E)的相关性。方法 :收集常年性变应性鼻炎可疑患者血清及鼻分泌物 ,测定其中粉尘螨 s Ig E并进行分析。结果 :血清及鼻分泌物中 ,粉尘螨 s Ig E浓度及其自然对数值间具有明显的相关性。结论 :测定可疑患者血清中粉尘螨 s Ig E可较好反映局部过敏程度 ;对部分局部表现和血清 s Ig E中情况不符者 ,测鼻分泌物 s Ig E更具诊断意义     

Nasal responsiveness to methacholine stimulation in allergic rhinitis patients

Summary We examined the nasal responsiveness to topical methacholine application in allergic rhinitis and non-allergic chronic rhinitis patients, and in control subjects. Methacholine responsiveness was significantly higher in allergic rhinitis patients than in non-allergic patients and control subjects. In perennial rhinitis, methacholine responsiveness correlated with the severity of daily nasal symptoms and those provoked by specific allergen challenge tests. Among nasal symptoms, hyper-rhinorrhoea was found to be closely related to methacholine responsiveness. As a result of these findings, the possibility of cholinergic hyper-reactivity in allergic rhinitis patients is discussed.     

鼻敏片对豚鼠变应性鼻炎鼻黏膜形态学的影响

目的观察鼻敏片对豚鼠变应性鼻炎鼻黏膜形态学的影响,证实其治疗作用.方法以TDI为致敏原,对豚鼠行鼻内给药法建立鼻超敏反应模型.造模成功后随机分为治疗组和对照组,分别予鼻敏片和息斯敏进行处理,观察比较两组鼻黏膜形态学.结果鼻敏片能抑制炎症细胞的聚集,促进鼻黏膜修复,对AR有明显治疗作用.结论鼻敏片能有效治疗变应性鼻炎,且较息斯敏有疗效持久、无副作用等优点.     

鼻中隔矫正和筛前神经电灼联用治疗鼻中隔偏曲伴变应性鼻炎

应用鼻中隔矫正术和（或）筛前神经电灼术治疗鼻中隔偏曲伴变应性鼻炎（ＰＡＲ）患者８６例。其中，Ａ组：２４例，用筛前神经电灼术治疗；Ｂ组：２９例，行矫正鼻中隔偏曲治疗；Ｃ组：３３例。以上述两法联合治疗。各组患者术后症状均立即停止发作，术后４周进行鼻粘膜抗原激发试验，得分均显著低于术前。术后１～２年随访，Ａ、Ｂ组都有少数病例复发，而Ｃ组无一例复发；术后５年随访Ａ、Ｂ组均有６０％的病例复发，而Ｃ组的复发率仅１２．５％。表明鼻中隔矫正术和筛前神经电灼术联用治疗鼻中隔偏曲伴ＰＡＲ，是一种较为理想的方法。