过敏原鼻激发试验研究进展及临床应用

Research progress and clinical application of allergen nasal provocation test

过敏原鼻激发试验(nasal provocation test,NPT)是指在标准、有控制的条件下将过敏原直接作用于鼻腔黏膜,以观察其是否可激发出变应性鼻炎(allergic rhinitis,AR)的主要症状,再现上呼吸道对受控条件下自然暴露的过敏原的反应,且是目前唯一可用的确认鼻腔对过敏原反应性的测试。它在研究AR的机制和评估新型抗过敏治疗反应方面具有非常重要的价值。NPT在临床实践中的作用越来越大,尤其在局部AR的鉴别、职业性AR的诊断、明确过敏原组分、AR治疗效果评价和进行过敏原免疫治疗的患者选择等方面作用更大、更广。本文综述了NPT在变应性和非变应性鼻炎等诊断中的应用,并对临床实践中使用NPT评估鼻腔反应的适应证、禁忌证、优点和局限性等进行介绍。

The allergen nasal provocation testing(NPT),in which allergens are applied directly to the nasal mucosa under standard and controlled conditions to provoke the main symptoms of allergic rhinitis(AR),reproduces the response of the upper respiratory tract to natural exposure to allergens under controlled conditions and is the only test currently available to confirm nasal reactivity to allergens.It is invaluable in studying the mechanisms of AR and in assessing the response to novel anti-allergic treatments.The test may play an increasingly important role in clinical practice,especially in the identification of local AR,the diagnosis of occupational AR,the clarification of the composition of allergens,the assessment of the efficacy of AR treatment and the selection of candidates undergoing allergen immunotherapy.This article reviewed the application of NPT in the diagnosis of allergic and non-allergic rhinitis,and also introduces the indications,contraindications,advantages and limitations of NPT in evaluating nasal response.