Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Republic of Korea.
Am J Rhinol Allergy. 2013 Mar-Apr;27(2):113-7. doi: 10.2500/ajra.2013.27.3870.
Nasal provocation tests (NPTs) are useful for evaluation of patients with allergic rhinitis. The cold dry air (CDA) provocation test is useful for evaluation of patients with nonspecific nasal hyperreactivity (NHR). This study aimed to determine whether the NPT or CDA provocation would be more useful for patients with different clinical pictures.
We evaluated changes in nasal symptoms (visual analog scale [VAS]) and acoustic parameters after NPT or CDA provocation in healthy volunteers (group A, n = 27), patients with allergic rhinitis (group B, n = 20), and subjects with nonallergic rhinitis (group C, n = 26). According to their subjective cold hyperresponsiveness (SCH), we compared changes in VAS and acoustic parameters after each protocol. The correlation between results of the skin-prick test (SPT) and changes in VAS after each protocol was analyzed. Finally, we performed an analysis of correlation between NPT and CDA provocation.
After NPT, group B showed a larger change in VAS for rhinorrhea, sneezing, and itching (p < 0.01). After CDA challenge, the change in VAS for nasal obstruction was larger in group C (p < 0.05). Changes in acoustic parameters were larger in groups B and C after NPT (p < 0.01). After CDA challenge, the SCH(+) group (n = 49) showed a larger decrease of acoustic parameters than the SCH(-) group (n = 24; p < 0.01). Significant correlation was observed between the size of SPT and degree of change in VAS after NPT. No significant correlation was observed between NPT and CDA.
CDA could be an adjunct tool for evaluating NHR in patients with self-reported SCH.
鼻激发试验（NPT）对于评估变应性鼻炎患者很有用。冷干空气（CDA）激发试验对于评估非特异性鼻高反应性（NHR）患者很有用。本研究旨在确定 NPT 或 CDA 激发对于不同临床特征的患者哪种更有用。
我们评估了健康志愿者（A 组，n = 27）、变应性鼻炎患者（B 组，n = 20）和非变应性鼻炎患者（C 组，n = 26）在 NPT 或 CDA 激发后鼻症状（视觉模拟评分[VAS]）和声学参数的变化。根据他们的主观冷超敏反应（SCH），我们比较了两种方案后 VAS 和声学参数的变化。分析了皮肤点刺试验（SPT）结果与每种方案后 VAS 变化之间的相关性。最后，我们分析了 NPT 和 CDA 激发之间的相关性。
在 NPT 后，B 组在流涕、打喷嚏和瘙痒方面的 VAS 变化更大（p < 0.01）。在 CDA 刺激后，C 组鼻塞的 VAS 变化更大（p < 0.05）。在 NPT 后，B 组和 C 组的声学参数变化更大（p < 0.01）。在 CDA 刺激后，SCH（+）组（n = 49）的声学参数下降幅度大于 SCH（-）组（n = 24；p < 0.01）。在 NPT 后，SPT 大小与 VAS 变化程度之间存在显著相关性。NPT 和 CDA 之间无显著相关性。
CDA 可作为评估自报 SCH 患者 NHR 的辅助工具。
