变应性鼻炎职业性变应原鼻激发试验的临床应用

Usefulness of nasal provocation tests in occupational rhinitis.

机构信息

Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, AP-HP, Creteil, France.

出版信息

Rhinology. 2009 Dec;47(4):432-7. doi: 10.4193/Rhin08.092.

DOI:10.4193/Rhin08.092

PMID:19936372

Abstract

OBJECTIVE

The aim of the study was to determine whether Nasal Provocation Tests (NPT) could help in the diagnosis of occupational rhinitis (OR).

METHODS

Changes in nasal airway resistance (NAR), measured by posterior rhinomanometry during specific nasal challenge associated with per and post test clinical scores, were compared to a prior probability, based on the patient's history, determined by occupational physicians, in 41 hairdressers and 33 bakers referred for suspected OR.

RESULTS

A DeltaNAR >or= 150% defined the positivity of the NPT. DeltaNAR demonstrated 50% sensitivity and a 86% specificity in hairdressers and a 95% sensitivity with 100 % specificity in bakers. DeltaNAR presented significant positive correlations with both per (p = 0.0003, r = 0.48) and post test clinical scores (p < 0.005, r = 0.39). The addition of clinical scores increased the sensitivity to 100% in hairdressers with 81% specificity.

CONCLUSIONS

The NPT constitutes a safe procedure of nasal reactivity with good levels of sensitivity and specificity in both hairdressers and bakers when nasal resistance and clinical scores are taken into account.

摘要

目的

本研究旨在确定鼻激发试验（NPT）是否有助于职业性鼻炎（OR）的诊断。

方法

通过后鼻测压法测量特定鼻挑战期间的鼻腔气道阻力（NAR）变化，并结合职业医生根据患者病史预先确定的概率（基于病史的先验概率），对 41 名美发师和 33 名面包师进行比较，这些美发师和面包师因疑似 OR 而接受检查。

结果

DeltaNAR≥150%定义了 NPT 的阳性。DeltaNAR 在美发师中的敏感性为 50%，特异性为 86%，在面包师中的敏感性为 95%，特异性为 100%。DeltaNAR 与即刻后临床评分均呈显著正相关（p=0.0003，r=0.48；p<0.005，r=0.39）。考虑到鼻腔阻力和临床评分，临床评分的增加使美发师的敏感性提高到 100%，特异性为 81%。