屋尘螨鼻激发试验与致敏状态和生命质量的相关性  

Correlation among Dermatophagoides pteronyssinus Nasal Provocation Test,Sensitization,and Quality of Life

作　　者：王万钧[1] 鲜墨[1] 谢燕清[1] 孙宝清[1] 韦妮莉[1] 李靖[1] 

机构地区：[1]呼吸疾病国家重点实验室,广州医学院第一附属医院变态反应科,广州510120

出　　处：《中华临床免疫和变态反应杂志》2012年第4期272-278,共7页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的探讨标准化屋尘螨鼻黏膜激发试验(NPT)与致敏状态和生命质量的相关性以及NPT对肺功能的影响。方法选取屋尘螨过敏的单纯变应性鼻炎患者35例,正常对照40例,分析屋尘螨NPT的阳性率以及与屋尘螨皮肤点刺试验(SPT)、屋尘螨血清特异性IgE(sIgE)、血清总IgE、鼻结膜炎生命质量问卷(RQLQ)的相关性,并分析对肺功能的影响。结果变应性鼻炎组屋尘螨NPT阳性率为97.1%,正常对照组为5.0%,两者比较差异有统计学意义(χ2=63.50,P<0.001)。NPT前后鼻部症状在变应性鼻炎组组间比较有显著性差异(P<0.001),而正常对照组组间比较差异无统计学意义(P>0.05),NPT前后鼻阻力在变应性鼻炎组和正常对照组组间比较均有显著性差异(P<0.01)。屋尘螨SPT指数、屋尘螨血清sIgE、总IgE的级别及RQLQ的评分级别越高,屋尘螨NPT鼻黏膜反应性的级别亦越高(P<0.001)。变应性鼻炎组肺功能指标FEV1/预计值%在NPT前为(96.8±13.4),NPT6h后为(95.2±14.7);对照组在NPT前为(99.2±9.4),NPT6h后为(97.7±9.2),两组比较差异无统计学意义(P>0.05)。结论变应性鼻炎患者对标准化屋尘螨NPT的反应率显著高于健康受试者,屋尘螨NPT的级别与受试者致敏状态的程度和生命质量呈显著相关,NPT对FEV1没有明显影响。Objective To investigate the correlation among the standardized Dermatophagoides pteronyssinus （ Der P） , nasal provocation test （NPT） and sensitizations as well as quality of life among participants, and the influence of NPT on lung function. Methods A total of 35 patients with allergic rhinitis without asthma and 40 normal controls were enrolled in this study. Skin prick test （SPT） against common allergens, serum specific IgE（sIgE） against house dust mites, serum total IgE, Der P NPT, and lung function test were performed, and Rhinoconjunctivitis Quality of Life Questionnaire （RQLQ） were also completed among the participants. Results The positive rate of Der P NPT was 97.1% （34/35） in patients with allergic rhinitis, while 5.0% （2/40） in normal control subjects （X^2 = 63.50, P 〈 0. 001 ）. The Visual analogue score scores of rhinitis symptoms increased significantly after Der P NPT in patients with allergic rhinitis （ P 〈0. 001 ）, while no difference in normal controls （P 〉 0.05）. The nasal airway resistance increased significantly after NPT in both patient and normal control subjects （P 〈0. 01 ）. Dose of Der P for NPT in all subjects was highly correlated with SPT index of Der P, titer of Der P sIgE , serum total IgE, and grade of score on RQLQ （P 〈0.001 ）. The percentage of forced expiratory volume in 1st second （FEV1） over predicted value in patients with rhinitis was 96. 8 ± 13.4 before NPT and 95.2 ± 14.7 after NPT respectively, while was 99.2 ± 9.4 before NPT and 97.7 ± 9.2 after NPT in controls respectively （ P 〉 0. 05）. Conclusions Standardized Der P NPT shows high correlation with sensitized status and quality of life in the subjects, but there is no influence on FEV1.

关 键 词：鼻黏膜激发试验 屋尘螨 变应性鼻炎 致敏 生命质量 

分 类 号：R392.8[医药卫生—免疫学] R765.21[医药卫生—基础医学]