特异性鼻粘膜激发试验中鼻气道的反应性

The study of the nasal airway reactivity in specific nasal provocation test

目的 :探讨对特异性鼻粘膜激发试验 ( SNPT)阳性的评价方法。方法 :对 3 0例常年性变应性鼻炎患者(鼻炎组 )和 14例正常成年人 (对照组 )进行 SNPT,观察鼻部症状及鼻气道阻力变化。结果 :激发后 ,鼻炎组绝大多数患者在 0 .5～ 3 .0 min内出现鼻痒、喷嚏、流清涕等症状。连续喷嚏 5个以上者占 83 .3 % ,与对照组 ( 2 1.4% )之间有显著性差异 ( P <0 .0 1) ;鼻腔总阻力和激发侧鼻阻力增加比例 ,两组间有明显差异 ,而两组对照液之间无明显差异。结论 :SNPT后 ,若出现明显的鼻部症状 ,激发侧鼻阻力增加 10 0 %以上 ,总鼻阻力增加 40 %以上 。

Objective:To explore efficient evaluation method for specific nasal provocation test(SNPT) and to observe the pathogenic process and patho physiological changes of allergic rhinitis.Method:30 patients with perennial allergic rhinitis(patients group)and 14 normal adults(controls group)were challenged unilaterally with the Coca′s solution and/or the solution for allergen extracts.The nasal resistance variations in all subjects were monitored with active anterior rhinomanometry and the nasal symptoms were observed. Result:The symptoms of nasal stiffness、sneezing and rhinorrhea appeared in most patients between 0.5 and 3 minutes after provocation.The ratio of continual sneezes above 5 in patients group( 83.3 %)was significantly higher than in controls group( 21.4 %)(P< 0.01 ).The increased ratio of total nasal resistance and unilaterally challenged nasal resistance were significantly higher in patients group than in controls group (P< 0.05 ) and no difference between coca′s solution in patients group and controls group.Conclusion:Positive SNPT was indicated if obvious nasal symptoms appeared and the unilaterally challenged nasal resistance increased 100% as well as the total nasal resistance increased 40% after SNPT.