鼻腔中央区变应性疾病研究进展

Progress in the study of central compartment allergic disease

鼻腔中央区变应性疾病(central compartment allergic disease,CCAD)是国际上新近命名的一种慢性鼻窦炎(chronic rhinosinusitis,CRS)亚型,其特征在于吸入性变应原在鼻腔中央区域黏膜产生2型炎症反应。早期可表现为局限于中鼻甲、上鼻甲及鼻中隔后上部位的黏膜水肿和息肉样变,进展后可导致邻近窦口发生阻塞,形成弥漫性鼻窦炎伴鼻息肉(diffuse sinus-itis with nasal polyps,CRSwNP),给治疗带来了更多挑战。文章就CCAD临床症状、内镜和影像学表现、致敏特点及组织病理学特征做一综述,总结CCAD与其他类型CRS的本质区别,为优化临床诊疗策略提供一定参考。

Central compartment allergic disease(CCAD)is a newly internationally named subtype of chronic rhinosinusitis(CRS)characterized by a type-2 inflammatory response of inhaled allergens in the mucosa of the central nasal region.In the early stage,it may manifest as mucosal edema and polypoid changes limited to the middle turbinate,superior turbinate and posterosuperior nasal septum.In the late stage,it may lead to obstruction of the adjacent sinus openings and progress to diffuse rhinosinusitis with nasal polyps,which poses more challenges for treatment.This article reviews the clinical symptoms,endoscopic and imaging manifestations,sensitization characteristics and histopathological features of CCAD,summarizes the essential differences between CCAD and other types of CRS,and provides some reference for optimizing clinical treatment strategies.