非变应性鼻炎患者的鼻与下气道炎症特征分析  

Analysis of the inflammation feature of the nasal and lower airway in patients with non-allergic rhinitis

作　　者：王志颐[1] 庞新举[1] 王秋萍[1] 张勇[1] 谢燕清[2] 钟南山[2] 

机构地区：[1]南京军区南京总医院耳鼻咽喉科,南京医学硕士210002 [2]广州医学院第一附属医院广州呼吸病研究所,广州510120

出　　处：《医学研究生学报》2014年第3期262-265,共4页Journal of Medical Postgraduates

基　　金：呼吸疾病国家重点实验室开放课题基金(2007DA780154F0907)

摘　　要：目的已有大量针对变应性鼻炎(allergic rhinitis,AR)对下气道影响的研究报道,但非变应性鼻炎(non-allergic rhinitis,NAR)患者下气道出现炎症性变化情况的相关研究尚不充分。文中探讨NAR鼻与下气道炎症状况。方法分别收集南京军区南京总医院及广州医学院第一附属医院2010年1-12月间初次就诊的NAR患者共计262例(NAR组)及健康体检者264例(对照组)。通过病史采集、皮肤点刺试验(skin prick test,SPT)、鼻灌洗、诱导痰、鼻激发和支气管激发检查等方式评价分析其炎症特征及对下气道的影响。结果与对照组比较,NAR组鼻灌洗嗜酸性粒细胞(eosinophil,EOS)计数[(6.21±16.95)vs(0.74±3.46)]、诱导痰EOS比例[(1.35±2.53)vs(0.44±1.27)]显著升高(P<0.05)。NAR组鼻激发阳性率为65.6%,与对照组(43.6%)的差异有统计学意义(χ2=25.62,P<0.01)。NAR组支气管激发阳性率6.1%,与对照组(1.1%)的差异有统计学意义(χ2=9.33,P<0.01)。NAR组鼻灌洗与诱导痰EOS增高均存在明显相关性(r=0.454,P=0.000)。结论 NAR患者鼻、下气道均存在EOS炎症和气道高反应性。NAR鼻、下气道EOS炎症存在一致性。Objective Rhinitis is divided into allergic rhinitis （AR） and non-allergic rhinitis （NAR）. There are a lot of re-searches focusing on the lower airway of AR patients, but the inflammatory changes in the lower airway of NAR patients remain unclear. This study is to explore the inflammatory characteristics of the nasal and lower airway in NAR. Methods From January to December 2010, 262 NAR patients and 264 healthy controls were enrolled in the present study. Medical history collection, skin prick test, nasal douche, induced sputum, nasal and bronchial provocation test were used to evaluate the inflanunatory characteristics of NAR and the effects of inflammation on lower airway. Results The eosinophil in nasal douche and induced sputum were significantly increased in the NAR group than the control group （P 〈0.01 ）. In the NAR group, nasal provocation positive rate was 65.6%, which was higher than 43.6% in the control group （P 〈0.01 ）. In the NAR group, bronchial provocation positive rate was 6.1%, which was higher than 1.1% in the control group （P 〈 0.01 ）. There was a significant correlation between the eosinophil in nasal douche and the induced sputum（r = O. 454, P = 0.000）in the NAR groups. Conclusion NAR patients were higher in EOS inflammation and airway hyperresponsiveness. In NAR patients, there is obvious correlation between the eosinophil in nasal and lower airway. When we were concerned about the status of nasal inflammation in patients with NAR, but also concerned about the status of the lower airway inflammation.

关 键 词：非变应性鼻炎 鼻灌洗 诱导痰 鼻激发 支气管激发 嗜酸性粒细胞 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]