Ghaem A, Dessanges J P, Lockhart A, Martineaud J P
Bull Eur Physiopathol Respir. 1986 Sep-Oct;22(5):443-9.
To examine the accuracy of nasal allergic disease, we examined the results of skin tests, measurement of serum specific IgE (RAST), and the nasal response to nasal challenge in 886 patients clinically suspected of having allergic respiratory disease. Nasal responses were assessed by measuring nasal airway resistance by both active anterior and posterior rhinomanometry. Nasal airway resistance was determined 25 min. after intranasal nebulization of saline solution and after administration of increasing doses of allergen (maximum dose = 280 micrograms). The dose of allergen causing a 100% increase over the value obtained after saline (Ri) at a flow rate of 0.15 l.s-1 was taken as the threshold dose (Dl). Our findings were that active anterior and posterior rhinomanometry yield comparable results; in subjects with a positive response to antigen challenge, the increase in nasal airway resistance correlated well with the dose of allergen administered and a significant inverse relationship was found between Ri and Dl; 3) a high level of serum specific IgE accurately predicted nasal responsiveness to a particular allergen, whereas skin tests were often positive to allergens that had no detectable effect on the nasal resistance. We conclude that nasal allergen provocation tests with rhinomanometric measurement of nasal resistance is a useful procedure for diagnosis of nasal allergic disease.
为了检验鼻变态反应性疾病的准确性，我们对886例临床怀疑患有变应性呼吸道疾病的患者进行了皮肤试验、血清特异性IgE（放射变应原吸附试验）测定以及鼻激发试验的鼻反应检查。通过主动前鼻测压法和后鼻测压法测量鼻气道阻力来评估鼻反应。在鼻内雾化生理盐水溶液25分钟后以及给予递增剂量的变应原（最大剂量 = 280微克）后测定鼻气道阻力。以在流速为0.15升/秒时使鼻气道阻力比生理盐水激发后的值增加100%（Ri）的变应原剂量作为阈值剂量（Dl）。我们的研究结果如下：1）主动前鼻测压法和后鼻测压法得出的结果相当；2）在对抗原激发试验有阳性反应的受试者中，鼻气道阻力的增加与所给予的变应原剂量密切相关，并且在Ri和Dl之间发现了显著的负相关；3）高水平的血清特异性IgE能准确预测鼻对特定变应原的反应性，而皮肤试验对那些对鼻阻力无明显影响的变应原常常呈阳性。我们得出结论，采用鼻阻力鼻测压法的鼻变应原激发试验是诊断鼻变态反应性疾病的一种有用方法。
