摘要
目的非变应性鼻炎伴嗜酸性粒细胞增高征（nonallergic rhinitis with eosinophilia syndrome,NARES）与支气管哮喘、鼻息肉、阿司匹林不耐受三联征等疾病相关,但对于其炎症状况研究相对较少,文中旨在探讨NARES患者鼻部、下气道及全身炎症特征。方法收集2014年1月至2014年12月初次在南京军区南京总医院耳鼻咽喉科就诊的变应性鼻炎（allergic rhinitis,AR）患者101例（AR组）、NARES患者39例（NARES组）及体检健康者（对照组）162例,通过病史采集、皮肤点刺实验、呼出气一氧化氮（fractional exhaled nitric oxide,Fe NO）、血常规、血总Ig E（total Ig E,t Ig E）、鼻灌洗鼻腔分泌物嗜酸性粒细胞（Eosi nophils,EOS）、诱导痰EOS、鼻激发和支气管激发检查等方式评价分析炎症状况。结果 NARES组、AR组鼻激发阳性率（69.2%、75.2%）、支气管激发阳性率（10.3%、14.9%）、Fe NO[（37.25±22.95）ppb、（39.00±24.29）ppb]较对照组[32.1%、1.2%、（15.70±5.20）ppb]均升高（P〈0.05）;NARES组、AR组血清Eos、血清t Ig E、鼻灌洗EOS计数、诱导痰EOS比例较对照组亦升高（P〈0.05）。NARES组血清t Ig E较AR组降低[53.3（23.3-186.0）vs 197.0（62.6-391.0）k U/L,P〈0.05]。结论 NARES患者鼻、下气道和全身均存在炎症反应,且炎症程度与AR无差异。临床上对NARES患者既要关注上气道炎症状况,也要关注下气道及全身炎症状况。
Objective Nonallergic rhinitis with eosinophilia syndrome（NARES） is associated with such diseases as bronchial asthma,nasal polyps,and aspirin intolerance,but there is a lack of studies on its inflammatory conditions.The aim of this study is to describe the inflammation characteristics of NARES.Methods This study included 101 cases of allergic rhinitis（AR）,39 cases of NARES,and 162 adult controls.We analyzed the inflammation characteristics of the patients using skin prick test（SPT）,nasal douche,fractional exhaled nitric oxide（FeNO） measurement,serum eosinophil（EOS） counting,serum total IgE（tIgE） determination,induced sputum detection,and nasal and bronchial provocation tests.Results Compared with the controls,the NARES and AR groups showed significant increases in the positive rate of nasal provocation（32.1% vs 69.2% and 75.2%,P〈0.05）,positive rate of bronchial provocation（1.2% vs 10.3% and 14.9%,P〈0.05）,and FeNO level（[15.70 ± 5.20]ppb vs [37.25 ± 22.95]and [39.00 ± 24.29]ppb,P〈0.05）,as well as in the serum EOS and tIgE levels,EOS count,and ratio of EOS in the induced sputum（P〈0.05）.However,the level of serum tIgE was significantly lower in the NARES than in the AR group（53.3 [23.3-186.0]kU/L vs 197.0 [62.6-391.0]kU/L,P〈0.05）.Conclusion NARES is a syndrome with nasal,lower airway,and systematic inflammation,similar to AR in inflammatory intensity.Therefore,for patients with NARES,attention should be paid not only to upper airway but also to lower airway and systemic inflammation.
出处
《医学研究生学报》
CAS
北大核心
2016年第7期727-730,共4页
Journal of Medical Postgraduates
基金
呼吸疾病国家重点实验室开放课题(2007DA780154F0907)
南京军区南京总医院科研基金(2013010)
关键词
变应性鼻炎
非变应性鼻炎伴嗜酸性粒细胞增高征
鼻灌洗
诱导痰
鼻激发
支气管激发
呼出气一氧化氮
Allergic rhinitis
Nonallergic rhinitis with eosinophilia syndrome
Nasal douche
Induced sputum
Nasal provocation test
Bronchial provocation test
Fractional exhaled nitric oxide
