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常年性鼻炎的鼻黏膜纤毛清除功能

Nasal mucociliary clearance in perennial rhinitis.

作者信息

Schuhl J F

机构信息

Allergologic Unit, Dermatology Clinic, Clinical Hospital, Montevideo, Uruguay.

出版信息

J Investig Allergol Clin Immunol. 1995 Nov-Dec;5(6):333-6.

PMID:8653221
Abstract

Mucociliary clearance is one of the homeostatic systems of the respiratory mucosa. Alterations in mucociliary clearance have been extensively studied in asthma, but less frequently in allergic rhinitis. In rhinitis, conflicting results have arisen: while some authors reported no change, others noticed a reduction in nasal mucociliary clearance. The aim of this study was to compare the nasal mucociliary clearance in allergic and non-allergic patients with perennial rhinitis and a healthy control group. One hundred and three patients and 14 healthy control subjects were studied. Nasal mucociliary clearance was assayed with the saccharin test modified with a food dye to add a visual parameter. Patients were divided into allergic and non-allergic rhinitis according to the presence of three of the following factors: total serum IgE above 180 KIU/L, positive skin prick tests to a battery of standardized allergens relevant to Uruguay, family and personal history of atopic diseases, and blood eosinophilia above 450 cells/mm3. The aspect of the nasal mucosa was not considered for categorizing the patients. Fifty-seven patients (29 males, mean age: 22.2 years) with allergic perennial rhinitis and 46 patients (15 males, mean age: 24.8 years) with non-allergic perennial rhinitis were compared with 14 controls (6 males, mean age: 35 years). A significant difference in nasal mucociliary clearance was observed between the three groups, with a mean of 8.8 minutes for the controls, 10.27 minutes for allergic rhinitis and 11.73 minutes for non-allergic patients. We suggest that the differences we observed were due to changes in the rheology of nasal mucus as a consequence of the underlying inflammatory process in rhinitis.

摘要

黏液纤毛清除功能是呼吸道黏膜的稳态系统之一。在哮喘中,关于黏液纤毛清除功能的改变已有广泛研究,但在变应性鼻炎中研究较少。在鼻炎方面,出现了相互矛盾的结果:一些作者报告无变化,而另一些作者则注意到鼻黏液纤毛清除功能降低。本研究的目的是比较常年性鼻炎的变应性和非变应性患者与健康对照组的鼻黏液纤毛清除功能。对103例患者和14名健康对照者进行了研究。采用添加食用色素以增加视觉参数的改良糖精试验测定鼻黏液纤毛清除功能。根据以下三个因素的存在情况将患者分为变应性和非变应性鼻炎:血清总IgE高于180 KIU/L、对一系列与乌拉圭相关的标准化变应原皮肤点刺试验阳性、特应性疾病的家族史和个人史以及血液嗜酸性粒细胞计数高于450个细胞/mm³。对患者进行分类时未考虑鼻黏膜的外观。将57例(29例男性,平均年龄:22.2岁)变应性常年性鼻炎患者和46例(15例男性,平均年龄:24.8岁)非变应性常年性鼻炎患者与14名对照组(6例男性,平均年龄:35岁)进行比较。三组之间鼻黏液纤毛清除功能存在显著差异,对照组平均为8.8分钟,变应性鼻炎患者为10.27分钟,非变应性患者为11.73分钟。我们认为,我们观察到的差异是由于鼻炎潜在炎症过程导致鼻黏液流变学改变所致。

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