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[职业性鼻炎和变应性结膜炎]

[Occupational rhinitis and allergic conjunctivitis].

作者信息

Endre László

机构信息

Vasút-egészségügyi Központ Budapest Gödöllői u. 3. 1141.

出版信息

Orv Hetil. 2014 Feb 1;155(5):170-5. doi: 10.1556/OH.2014.29786.

Abstract

Occupational rhinitis is an inflammatory disease of the nose, which is characterised by intermittent or persistent symptoms, arising from causes and conditions attributable to a particular work environment and not from stimuli encountered outside the workplace. Its clinical symptoms such as nasal congestion, sneezing, rhinorrhoea, itching, nasal airflow limitation are very similar to the symptoms of allergic rhinitis caused by other (classical) agents. Occupational allergic conjunctivitis is an IgE mediated disease, provoked by a substance in the air of the workplace. Its clinical signs (itching, tearing, conjunctival hyperaemia and oedema and, in some cases when the cornea is also involved, blurred vision, photosensitivity) are similar to other forms of allergic conjunctivitis. Risk factors (which in most of the cases occur in both diseases) include history of atopy, high concentration of the irritant agent and multiple irritant agents in the air of the workplace. Atopy has been associated with an increased risk of specific sensitisation to a variety of high molecular weight agents. For the diagnosis of occupational rhinitis and occupational allergic conjunctivitis objective investigations such as allergen specific provocations are necessary in addition to clinical and occupational history. Management of these occupational diseases needs environmental interventions (increasing ventilation, decreasing the time of exposure, substitution of the irritant agent). Medical treatment of occupational rhinitis is very similar to other allergic diseases: oral antihistamines, local (nasal) corticosteroids, combined (antihistamine plus membrane stabilizer) eyedrops. The most important step in medical treatment of occupational allergic conjunctivitis is the daily application of combined eyedrops (for example: olopatadine). Orv. Hetil., 2014, 155(5), 170-175.

摘要

职业性鼻炎是一种鼻部炎症性疾病,其特征为间歇性或持续性症状,由特定工作环境中的病因和条件引起,而非工作场所以外遇到的刺激所致。其临床症状如鼻塞、打喷嚏、流涕、瘙痒、鼻气流受限等,与其他(典型)因素引起的过敏性鼻炎症状非常相似。职业性变应性结膜炎是一种由工作场所空气中的物质引发的IgE介导的疾病。其临床体征(瘙痒、流泪、结膜充血和水肿,在某些角膜也受累的情况下还会出现视力模糊、畏光)与其他形式的变应性结膜炎相似。危险因素(在大多数情况下两种疾病都存在)包括特应性病史、刺激性物质浓度高以及工作场所空气中存在多种刺激性物质。特应性与对多种高分子量物质发生特异性致敏的风险增加有关。对于职业性鼻炎和职业性变应性结膜炎的诊断,除临床和职业病史外,还需要进行过敏原特异性激发试验等客观检查。这些职业病的管理需要环境干预(增加通风、减少暴露时间、替代刺激性物质)。职业性鼻炎的药物治疗与其他过敏性疾病非常相似:口服抗组胺药、局部(鼻用)皮质类固醇、联合(抗组胺药加膜稳定剂)眼药水。职业性变应性结膜炎药物治疗中最重要的一步是每日应用联合眼药水(例如:奥洛他定)。《匈牙利医学周报》,2014年,155(5),170 - 175页

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