中国华南地区局部变应性鼻炎患者的临床特征

Clinical Characteristics in Patients with Local Allergic Rhinitis from Southern China

【目的】探讨局部变应性鼻炎患者在中国华南地区的临床特征,为临床上对局部变应性鼻炎(LAR)诊治提供理论基础。【方法】收集63例临床表现符合鼻炎的患者的病例资料、血清及鼻腔分泌物,并检测血清及鼻腔分泌物中4种变应原特异性Ig E水平,比较LAR在发病情况、病史、相关症状评分、变应原等方面与变应性鼻炎(AR)、非变应性鼻炎(NAR)的异同点。【结果】63位鼻炎患者中有9位(14.3%)能诊断为LAR,患者年龄平均40(S=15)岁,鼻部或/和眼部症状的病史大多超过10年,过敏性结膜炎和支气管哮喘为常见的并发症。LAR比NAR患者的鼻痒症状评分显著性升高(P=0.011),且具有更高的总眼部症状评分(P=0.008)。AR比LAR患者更倾向于对屋尘螨及粉尘螨过敏(P<0.001),而LAR患者比AR患者倾向于对花粉过敏(P<0.001)。LAR患者鼻腔分泌物s Ig E水平比AR患者低,差异有统计学意义(P=0.003)。【结论】在中国华南地区约1/7的鼻炎患者可能存在LAR。通过鼻部及眼部症状评分可初步对LAR与NAR鉴别,对高度怀疑由过敏因素导致的NAR可进行鼻腔分泌物s Ig E检测。

[ Objective ] This study aimed to analyze the clinical characteristics of local allergic rhinitis （LAR） in Chinese patients from South China. [ Methods ] A total of 63 patients who met our inclusion criteria were selected out of the patients who were diagnosed with rhinitis in our clinic and included in this study. Clinical questionnaires were used to evaluate the persistence and severity of the patients＇ symptoms. The patients＇ serum and nasal secretion samples were both tested for allergen specific IgE （sIgE） against four aeroallergens, respectively, including Dermatophagoides pteronyssinus, Dermatophagoides farinae, pollen and mold. [Results] The percentages of local allergic rhinitis were 14.3%. LAR had significantly higher itching symptom score （P = 0.011） and TOSS （P = 0.008） than NAR. LAR patients had the similar clinical characteristics with those of AR patients, except that grass pollen was the main sensitizing aeroallergen in LAR. Additionally, a significant lower sIgE level in nasal secretion was observed in LAR patients compared with AR patients （P = 0.003）. [Conclusion] Local allergic rhinitis （LAR） was diagnosed in one seventh of the rhinitis patients in our study. Itching symptom score and TOSS were much higher in LAR group than in NAR group. Therefore, they may be a useful tool to differentiate LAR from NAR. In order not to neglect the existence of LAR, rhinitis patients without systemic atopy should be examined for nasal and ocular symptom scores and tested for local sIgE, especially against pollen, both at initial and follow-up examinations.