Jung Chang Gyu, Lee Ji Ho, Ban Ga Young, Park Hae Sim, Shin Yoo Seob
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Yonsei Med J. 2017 Sep;58(5):1047-1050. doi: 10.3349/ymj.2017.58.5.1047.
Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The aim of this study was to evaluate the prevalence and clinical characteristics of LAR in Korean rhinitis patients compared to allergic rhinitis (AR) and non-allergic rhinitis (NAR). A total of 304 rhinitis patients were enrolled from November 2014 to March 2016. A skin prick test, serum total and specific immunoglobulin E, and a nasal provocation test (NPT) with house dust mite (HDM) were performed on all patients. Subjects also documented changes in rhinitis symptoms before and after NPT. Seventy-four patients with nasal hyper-reactivity and 80 patients with subclinical allergy were excluded. AR was diagnosed in 69 (46.0%) patients, NAR in 75 (50.0%) patients, and LAR to HDM in 6 (4.0%) patients. The average medication score and disease duration of each group were 14.5 points and 77.6 months in AR, 12.1 point and 51.1 months in NAR, and 17.7 point and 106.0 months in LAR, respectively. There were no significant differences in the baseline nasal symptom score of the three groups. However, after NPT with HDM, the score of rhinitis, itching, and obstructive were 4.83±1.47 vs. 1.95±2.53, 3.00±2.10 vs. 1.45±2.06, and 5.50±1.38 vs. 2.57±2.84 in LAR and NAR, respectively (p<0.05). LAR patients had longer duration of disease and tended to be older and have higher medication score than other rhinitis patients.
局部变应性鼻炎（LAR）是一种无全身特应性的局部鼻部变应性反应。本研究的目的是评估韩国鼻炎患者中LAR的患病率和临床特征，并与变应性鼻炎（AR）和非变应性鼻炎（NAR）进行比较。2014年11月至2016年3月共纳入304例鼻炎患者。对所有患者进行了皮肤点刺试验、血清总免疫球蛋白E和特异性免疫球蛋白E检测，以及用屋尘螨（HDM）进行的鼻激发试验（NPT）。受试者还记录了NPT前后鼻炎症状的变化。排除74例鼻高反应性患者和80例亚临床过敏患者。诊断为AR的患者69例（46.0%），NAR的患者75例（50.0%），对HDM呈LAR的患者6例（4.0%）。AR组、NAR组和LAR组的平均用药评分和病程分别为14.5分和77.6个月、12.1分和51.1个月、17.7分和106.0个月。三组的基线鼻部症状评分无显著差异。然而，在用HDM进行NPT后，LAR组和NAR组的鼻炎、瘙痒和鼻塞评分分别为4.83±1.47对1.95±2.53、3.00±2.10对1.45±2.06、5.50±1.38对2.57±2.84（p<0.05）。LAR患者的病程较长，年龄往往较大，用药评分高于其他鼻炎患者。
