Amabile G, Pignataro L D, Di Cicco M, Biondo B
Istituto di Clinica Otorinolaringoiatrica II, Università di Milano.
Acta Otorhinolaryngol Ital. 1994 Nov-Dec;14(6):643-9.
The Authors examined 55 patients divided into two groups, one of 30 vasomotor rhinopatic patients and the other of 25 normal subjects. The aim of the study was to set up an objective diagnostic rhinomanometer test through observation and evaluation of reaction brought about by physical exertion following an exertion test of 5 minutes which employed a computerized climb simulator. Nasal resistance was measure before and immediately after exertion and then at intervals of 10, 20 and 50 minutes. Our data reveal a noteworthy decrease in nasal resistance brought about by the sympathetic nervous system in normal and rhinopathic subjects. Return to pre-exertion values, however occurred difference in the two groups: in the control group nasal resistance returned to pre-exertion values slowly, while in the rhinopathic group, it decreased rapidly and a rebound effect was observed. In vasomotor rhinopathy the orthosympathetic system is overcome by the para sympathetic system with regard to nasal vascularization control and, therefore, in rhinopatic patients exertion stimulates efficacions activation of the orthosympathetic system a phenomenon which does not occur in healthy subject. On the basis of our results an intensive stimulus such as physical exertion seems to have a different effect on the two groups suggesting that the vessels of nasal mucosa do not always respond in the same way, and that in vasomotor patients there is an alternate reactivity of neural control of nasal mucosa. The rhinomanometric exercise test seems to be useful in revealing this phenomenon and to be diagnostically reliable. The method is easily reproducible, non-invasive and can be usefully applied in clinical practice associated with the normal rhinomanometric challenge test.
作者对55名患者进行了检查，将其分为两组，一组是30名血管运动性鼻炎患者，另一组是25名正常受试者。该研究的目的是通过观察和评估在使用计算机化爬坡模拟器进行5分钟运动测试后体力活动所引起的反应，建立一种客观的诊断性鼻阻力计测试。在运动前、运动后立即以及之后每隔10、20和50分钟测量鼻阻力。我们的数据显示，正常受试者和鼻炎患者的交感神经系统均导致鼻阻力显著降低。然而，两组在恢复到运动前值方面存在差异：在对照组中，鼻阻力缓慢恢复到运动前值，而在鼻炎组中，鼻阻力迅速下降，并观察到反弹效应。在血管运动性鼻炎中，就鼻血管化控制而言，副交感神经系统克服了交感神经系统，因此，在鼻炎患者中，运动刺激了交感神经系统的有效激活，而这种现象在健康受试者中不会发生。根据我们的结果，诸如体力活动这样的强烈刺激对两组似乎有不同的影响，这表明鼻黏膜血管并非总是以相同的方式作出反应，并且在血管运动性鼻炎患者中存在鼻黏膜神经控制的交替反应性。鼻阻力计运动测试似乎有助于揭示这种现象，并且在诊断上是可靠的。该方法易于重复，无创，并且可以与常规鼻阻力计激发试验一起有效地应用于临床实践。
