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[慢性荨麻疹的诊断。基于病史研究对检测结果的批判性分析]

[Diagnosis of chronic urticaria. Critical analysis of test results based on catamnestic studies].

作者信息

Paul E, Dominante G

机构信息

Zentrum für Dermatologie und Andrologie, Justus-Liebig-Universität Giessen.

出版信息

Z Hautkr. 1988 Nov 15;63(11):917-20, 925.

PMID:3239137
Abstract

305 patients suffering from chronic urticaria were tested according to a special program, which combined the common allergologic skin testing with the searching for foci of inflammation. The central part of the diagnosis, however, are oral provocation tests during potato/rice diet with non-steroidal antiphlogistic agents and so-called food additives as well as "natural" salicylates. Acetylsalicylic acid and indomethacin most frequently caused reactions of intolerance, whereas all of the patients tolerated paracetamol (500 mg) without any reactions. With food additives and "natural" salicylates, intolerance reactions were rare. In our patients, skin testing only rarely led to any relevant results; the search for foci, instead, led to numerous findings, which, however, seemed not to have much influence on the further course of the disease. Apparently, the healing rate was neither influenced by the reactions of intolerance, nor the fact whether the patient had got a proper diet or not; we suggest, therefore, that the interpretation of the test results should be reconsidered.

摘要

305名慢性荨麻疹患者按照一个特殊方案进行了检测,该方案将常见的变应性皮肤试验与寻找炎症病灶相结合。然而,诊断的核心部分是在食用土豆/米饭饮食期间,使用非甾体抗炎药以及所谓的食品添加剂和“天然”水杨酸盐进行口服激发试验。乙酰水杨酸和吲哚美辛最常引起不耐受反应,而所有患者对扑热息痛(500毫克)均耐受,无任何反应。对于食品添加剂和“天然”水杨酸盐,不耐受反应很少见。在我们的患者中,皮肤试验很少能得出任何相关结果;相反,寻找病灶却有许多发现,然而,这些发现似乎对疾病的进一步发展没有太大影响。显然,治愈率既不受不耐受反应的影响,也不受患者是否遵循了适当饮食这一事实的影响;因此,我们建议应重新考虑对检测结果的解读。

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