Bozek Andrzej, Ignasiak Beata, Kasperska-Zajac Alicja, Scierski Wojciech, Grzanka Alicja, Jarzab Jerzy
Clinical Department of Internal Disease, Dermatology, and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland.
Outpatient Clinic of Allergy, Swietochlowice, Poland.
Ann Allergy Asthma Immunol. 2015 Mar;114(3):199-202. doi: 10.1016/j.anai.2014.12.013.
Local allergic rhinitis (LAR) is characterized by the production of specific IgE in the nasal mucosa and a positive response to a nasal provocation test in the absence of atopy by conventional measurements. There is no information about LAR in elderly people, just as there is little information about allergic rhinitis (AR) in this age group.
To investigate the prevalence of LAR, AR, and non-AR in elderly patients with rhinitis.
In 219 patients with a mean (SD) age of 65.81 (5.88), skin prick tests, serum total specific IgE, and nasal provocation tests against common aeroallergens were performed. In addition, nasal specific IgE was measured in the nasal lavage at baseline and after provocation. For monitoring nasal symptoms, a visual analog scale was used.
Of the 219 patients, 46 (21.0%) had LAR, 88 (40.2%) had AR, and 85 (38.8%) were diagnosed as having non-AR. Dermatophagoides pteronyssinus was the main sensitizing aeroallergen in patients with LAR (29 patients [63.0%]) and with AR (48 patients [56.4%]). No significant differences were found between the visual analog scale score and the type of AR (local or nonlocal) and the types of allergens. Clinical responses during the nasal provocation test were associated with significant increases in nasal IgE (Spearman correlation test, R = 0.89, P < .05). Polysensitization was more predominant in patients with AR than in those with LAR (P < .05).
The results indicate that LAR and AR are common in elderly patients. However, in this age group, these conditions are often underdiagnosed.
局部变应性鼻炎（LAR）的特征是鼻黏膜产生特异性IgE，且在常规检测无特应性的情况下对鼻激发试验呈阳性反应。目前尚无关于老年人LAR的信息，就如同关于该年龄组变应性鼻炎（AR）的信息也很少一样。
调查老年鼻炎患者中LAR、AR和非AR的患病率。
对219例平均（标准差）年龄为65.81（5.88）岁的患者进行针对常见气传变应原的皮肤点刺试验、血清总特异性IgE检测及鼻激发试验。此外，在基线和激发后测量鼻灌洗液中的鼻特异性IgE。采用视觉模拟量表监测鼻部症状。
在219例患者中，46例（21.0%）患有LAR，88例（40.2%）患有AR，85例（38.8%）被诊断为非AR。屋尘螨是LAR患者（29例[63.0%]）和AR患者（48例[56.4%]）的主要致敏气传变应原。视觉模拟量表评分与AR类型（局部或非局部）及变应原类型之间未发现显著差异。鼻激发试验期间的临床反应与鼻IgE的显著升高相关（Spearman相关检验，R = 0.89，P <.05）。AR患者的多致敏现象比LAR患者更常见（P <.05）。
结果表明LAR和AR在老年患者中很常见。然而，在这个年龄组中，这些疾病常常诊断不足。
