哮喘对变应性鼻炎患者鼻腔黏膜功能的影响  

The impact of asthma on nasal function in patient with allergic rhinitis

作　　者：廖剑绚[1] 陈祖尧[2] 

机构地区：[1]南华大学附属第一医院耳鼻咽喉科,湖南衡阳421001 [2]南华大学附属南华医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第20期1601-1604,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：湖南省教育厅科学研究项目(No:13C803);衡阳市科学技术发展计划项目(No:2015KJ46)

摘　　要：目的:研究同时患有变应性鼻炎(AR)和哮喘的患者下呼吸变态反应性炎症对鼻腔黏膜功能的影响,以探讨上下呼吸道炎症一致性的发病机制及临床意义。方法:将患者分为AR组、AR合并哮喘组和正常鼻黏膜组;利用糖精实验检测患者鼻黏液纤毛传输速度,pH试纸检测患者鼻黏膜pH值,采用前鼻主动测压法测量鼻腔总阻力,使用免疫荧光法检测鼻腔灌洗液中嗜酸粒细胞阳离子蛋白(ECP)的含量。结果:AR组黏液纤毛传输速度平均为13.40mm/min,AR合并哮喘组为15.51mm/min,正常鼻黏膜组为8.03mm/min,三组都存在显著性差异;AR组鼻黏膜pH值平均为6.39,AR合并哮喘组为6.36,正常鼻黏膜组为6.67,AR组和AR合并哮喘组鼻黏膜pH值与正常鼻黏膜组相比均明显降低,但AR组和AR合并哮喘组相比无明显差异;AR组鼻腔总阻力值平均为0.579Pa/(cm3·s),AR合并哮喘组为0.590Pa/(cm3·s),正常鼻黏膜组为0.424Pa/(cm3·s),AR组和AR合并哮喘组鼻腔总阻力值与正常鼻黏膜组相比均明显升高,但AR组和AR合并哮喘组相比无明显差异;AR组鼻腔灌洗液中ECP的含量平均为27.98μg/L,AR合并哮喘组为35.74μg/L,正常鼻黏膜组为4.92μg/L,三组存在显著性差异。结论:AR患者合并哮喘时,哮喘的反复发病对鼻黏膜的纤毛传输功能产生了一定影响,哮喘促进AR在发病过程中降低鼻黏膜纤毛的功能,同时也促进了AR患者鼻黏膜中嗜酸粒细胞的浸润,从而加重和促进了AR的发病。Objective：To observe the impact of lower allergic respiratory inflammation on nasal function in patient with allergic rhinitis.Method：Patients were divided into three group：allergic rhinitis group,allergic rhinitis with asthma group and control group;the nasal mucociliary transporting rate was evaluated by saccharin test;The pH of nasal mucosa extraction was evaluated by pH test paper;the nasal resistance was evaluated by nasal resistance instrument;the content of eosinophil cationic protein of nasal lavage fluid was evaluated by immunofluorescence.Result：The nasal mucociliary transporting rate was 13.40mm/min,15.51mm/min,and 8.03mm/min in allergic rhinitis group,allergic rhinitis with asthma group and control group,respectively;The pH of nasal mucosa was 6.39,6.36 and 6.67,respectively,while the pH of allergic rhinitis group and allergic rhinitis with asthma group were significantly higher than control group;the nasal resistance was 0.579Pa/（cm3·s）,0.590Pa/（cm3·s）,and 0.424Pa/（cm3·s）in allergic rhinitis group,allergic rhinitis with asthma group and control group,respectively,and the nasal resistance of allergic rhinitis group and allergic rhinitis with asthma group were significantly higher than control group;the content of eosinophil cationic protein of nasal lavage fluid was27.98μg/L,35.74μg/L,and 4.92μg/L,respectively.Conclusion：The recurrent attack of asthma could lower nasal mucociliary transporting rate in patient with allergic rhinitis,promote the infiltration of EOS in nasal mucosa.In conclusion asthma could play an important role in the pathogenesis of allergic rhinitis.

关 键 词：哮喘 鼻炎 变应性 鼻黏膜 嗜酸粒细胞 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]