J Investig Allergol Clin Immunol. 2014;24(1):1-5.
Chronic spontaneous urticaria (CSU) is defined as the presence of urticaria with daily or almost daily symptoms for 6 weeks or more. CSU affects 0.1%-0.8% of the population. Its pathogenesis involves autoimmunity, abnormalities in signal transduction, and the action of histamine on H1 receptors. Investigation of CSU should be guided by a thorough history and physical examination. A concise laboratory evaluation, including the CU index, is recommended. This index can provide useful data on severity and response to therapy. Initial treatment should involve increasing doses of nonsedating antihistamines until the intended effect is achieved. Only when a patient is unresponsive to high-dose nonsedating antihistamines (or sedating antihistamines) can we consider CSU refractory and consider immunomodulatory therapy. The most promising drugs are cyclosporine and, more recently, omalizumab.
慢性自发性荨麻疹（CSU）定义为荨麻疹每日或几乎每日发作，持续 6 周或以上。CSU 影响人群的 0.1%-0.8%。其发病机制涉及自身免疫、信号转导异常和组胺对 H1 受体的作用。CSU 的调查应根据详细的病史和体格检查进行。推荐进行简洁的实验室评估，包括 CU 指数。该指数可提供有关严重程度和治疗反应的有用数据。初始治疗应包括增加非镇静抗组胺药的剂量，直到达到预期效果。只有当患者对高剂量非镇静抗组胺药（或镇静抗组胺药）无反应时，我们才能考虑 CSU 难治性，并考虑免疫调节治疗。最有前途的药物是环孢素和最近的奥马珠单抗。
