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鼻激发试验在职业性鼻炎诊断中的应用。

Use of nasal provocation test in the diagnostics of occupational rhinitis.

作者信息

Airaksinen Liisa, Tuomi Timo, Vanhanen Markku, Voutilainen Risto, Toskala Elina

机构信息

Finnish Institution of Occupational Health, Centre of Expertise for Health and Work Ability, Helsinki, Finland.

出版信息

Rhinology. 2007 Mar;45(1):40-6.

Abstract

OBJECTIVES

The purpose of the study was to evaluate the usefulness and clinical value of the nasal provocation test (NPT) with various allergens and non-IgE-mediated irritants in the diagnostics assessing occupational rhinitis.

METHODS

A large number nasal provocation data from patients with suspected occupational rhinitis was evaluated retrospectively. The results of nasal provocation tests with different agents, as well as the correlation of nasal scoring to weighed mucus secretion, were analyzed.

RESULTS

Altogether 507 NPTs were done in three years in 165 persons. In total, 39% of the allergen provocations (125/318) were positive. The most common positive reactions were against flours, animal epithelia, storage mites and various plants. Wood dusts, mainly through non-IgE-mediated reactions, gave 50% positive results. Positive NPTs to moulds were observed mainly in sensitized patients. Altogether, 10% of the control provocations were positive. The weighting of mucus secretion added sensitivity of NPT.

CONCLUSIONS

The NPT is an essential standard tool in the diagnostics of allergic occupational rhinitis; however it needs to be evaluated in the context of the medical and work history and knowledge of sensitization. Although expensive and laborious, NPT is safe and easy for the patient. We still need reliable diagnostic tools for non-allergic work-related rhinitis.

摘要

目的

本研究旨在评估使用多种过敏原和非IgE介导的刺激物进行鼻激发试验(NPT)在诊断职业性鼻炎中的实用性和临床价值。

方法

回顾性评估大量疑似职业性鼻炎患者的鼻激发试验数据。分析不同试剂鼻激发试验的结果,以及鼻评分与黏液分泌量的相关性。

结果

3年内在165人中共进行了507次鼻激发试验。总体而言,39%的过敏原激发试验(125/318)呈阳性。最常见的阳性反应针对面粉、动物上皮、仓储螨和各种植物。木尘主要通过非IgE介导的反应,阳性率为50%。对霉菌的阳性鼻激发试验主要见于致敏患者。总体而言,10%的对照激发试验呈阳性。黏液分泌量的加权增加了鼻激发试验的敏感性。

结论

鼻激发试验是诊断变应性职业性鼻炎的重要标准工具;然而,需要结合病史、工作史和致敏知识进行评估。尽管鼻激发试验昂贵且费力,但对患者来说安全且操作简便。我们仍需要用于诊断非变应性职业性鼻炎的可靠诊断工具。

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