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目的:研究变应性鼻炎患者变应原的分布情况及其和鼻黏膜激发实验的相关性,以确定阳性变应原不同等级在诊断变应性鼻炎中的可靠性。方法:采用阿罗格公司生产的标准化变应原试剂,对有临床症状和体征的1400例患者进行了吸入性变应原的皮肤点刺实验,同时选择阳性变应原不同等级的各30例螨阳性的患者行鼻黏膜激发实验,以评价两者的相关性。结果:变应原阳性患者1 088例(78%),其中螨过敏890例(81.8%);单纯常年性变应原阳性率为52.2%(568例),单纯性季节性变应原为35.7%(388例),两者皆有者12.1%(132例)。阳性变应原等级为+++和++++患者鼻黏膜激发实验皆为阳性,等级为++的有1例为阴性,等级为+的患者中鼻黏膜激发实验有9例为阴性,而在变应原为阴性的患者中有5例为阳性。结论:变应原阳性等级较高的患者其鼻黏膜激发实验皆为阳性,而在较低等级阳性患者中有假阳性发生,在变应原实验为阴性患者中亦存在假阴性。因此临床上在挑选患者行免疫治疗前,应考虑上述情况。
OBJECTIVE: To investigate the distribution of allergens and their association with nasal mucosal challenge in patients with allergic rhinitis to determine the reliability of different grades of positive allergens in the diagnosis of allergic rhinitis. METHODS: A total of 1,400 patients with clinical signs and symptoms underwent dermal prick testing of inhaled allergens using standard allergen reagents from Arroyo and 30 patients of varying grades of positive allergens Mite-positive patients underwent nasal mucosal stimulation experiments to evaluate the correlation between the two. Results: 1 088 cases (78%) were allergen-positive patients, of which 890 cases were allergic to mites (81.8%). The positive rate of perennial allergens was 52.2% (568 cases) and the simple seasonal allergen was 35.7 % (388 cases), both were 12.1% (132 cases). Positive allergen grade +++ and ++++ patients were all positive for nasal mucosal challenge, with one negative for grade ++ and nine for negative nasal mucosal challenge in patients with grade + In the allergen-negative patients, 5 were positive. CONCLUSIONS: Nasal mucosal challenge tests were positive in patients with a high positive allergen level, false positives in lower-grade positive patients, and false-negatives in patients with negative allergen tests. Therefore, clinically in the selection of patients before immunotherapy, should consider the above situation.