Semik-Orzech Aleksandra, Gasior Grzegorz, Barczyk Adam, Pierzchała Władysław
Katedry i Kliniki Pneumonologii Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2006;59(5-6):396-402.
Allergic rhinitis is a frequent immunological disease affecting about 10-25% of the total population. The pathogenesis of allergic rhinitis is presumed to involve an IgE-mediated mechanism. Careful patient history, together with the skin prick test or RAST, usually allows an easy diagnosis of allergic rhinitis. In other cases it may be necessary to confirm diagnosis by the nasal provocation test. Different methods of provocation and measurement of nasal responses have been used in recent years. Scoring of the severity of clinical symptoms is too subjective to be clinically useful and should therefore be supplemented by one of the objective measurement techniques, such as anterior rhinomanometry. Additional analysis of nasal cytologic findings and determination of biomarkers in nasal secretions can be a critical tool in the evaluation of pathophisiology of allergic rhinitis. We critically discuss indications and contraindications for nasal challenges and review current techniques of provocation. We also provide various methods of assessment of nasal responses. The included examples of nasal provocation tests protocols may be helpful in introducing nasal provocation tests into everyday clinical practice.
变应性鼻炎是一种常见的免疫性疾病，影响着约10%-25%的总人口。变应性鼻炎的发病机制推测涉及IgE介导的机制。详细的患者病史，结合皮肤点刺试验或放射性变应原吸附试验，通常可轻松诊断变应性鼻炎。在其他情况下，可能需要通过鼻激发试验来确诊。近年来已采用了不同的激发方法和鼻反应测量方法。临床症状严重程度评分主观性太强，在临床上用处不大，因此应由一种客观测量技术（如前鼻测压法）加以补充。鼻细胞学检查结果的进一步分析以及鼻分泌物中生物标志物的测定可能是评估变应性鼻炎病理生理学的关键工具。我们批判性地讨论了鼻激发试验的适应证和禁忌证，并回顾了当前的激发技术。我们还提供了评估鼻反应的各种方法。所包含的鼻激发试验方案示例可能有助于将鼻激发试验引入日常临床实践。
