不同螨致敏原对变应性鼻炎患者生活质量的影响

目的 探讨屋尘螨(Dermatophagoides pteronyssinus, Der p)、粉尘螨(Dermatophagoides farinae, Der f)和热带螨(Blomia tropicalis, Blo t)对变应性鼻炎患者生活质量的影响是否存在差异.方法 对236例变应性鼻炎患者行标准化屋尘螨疫苗特异性免疫治疗,观察患者皮肤点刺试验(skin prick test, SPT)结果.在免疫治疗前分别进行鼻结膜炎症状问卷调查(rhinoconjunctivitis symptom questionnaire, RSQ)和鼻结膜炎患者生活质量问卷调查(rhinoconjunctivitis quality of life questionnaire, RQLQ).通过对调查结果的分析判断,对比3种螨对患者RSQ和RQLQ的影响.结果 SPT结果在Der p、Der f和Blo t中的总阳性率分别为97.87%(231)、97.87%(231例)和61.28%(145例);患者的RSQ和RQLQ评分分别为(9.64±3.72)分和(26.56±15.30)分.通过多元线性回归分析,3种螨对患者RSQ和RQLQ的影响差异均无统计学意义(P>0.05).结论 Der p、Der f和Blo t对变应性鼻炎患者生活质量的影响无差别.     

儿童过敏性结膜炎与变应性疾病的相关性

目的评价儿童过敏性结膜炎与变应性鼻炎、哮喘及湿疹的相关性。方法对2005年9月～2006年9月在本院就诊的407例儿童过敏性结膜炎进行回顾性分析。对其鼻炎、哮喘、湿疹以及父母的过敏性疾病进行问卷式调查。对其中256例患者利用酶联吸附试验进行血清总IgE和特异性IgE分析。结果407例过敏性结膜炎中分别有292例(占71.7%)、376例(占92.4%)和115例(占28.2%)同时患有湿疹、鼻炎和哮喘,合并鼻炎者明显高于合并湿疹和哮喘者(P<0.05)。256例血清总IgE和特异性IgE检测中,吸入组230例中有228例(99.1%)总IgE呈阳性,食入组200例中198例(99.0%)总IgE呈阳性;吸入性过敏原以螨和屋尘为主,食入性过敏原以鱼、蟹、虾为主。慢性过敏性结膜炎的过敏原主要是螨、屋尘和鱼,与急性过敏性结膜炎的差异有统计学意义(P<0.05)。而急性过敏性结膜炎的过敏原主要是花粉和蒿草,与慢性过敏性结膜炎差异有统计学意义(P<0.05)。结论儿童过敏性结膜炎常与鼻炎、哮喘及湿疹同时发病,单独发病较少,其中儿童过敏性结膜炎与鼻炎发病尤为密切,故在儿童期联合治疗两种疾病将对防治鼻炎和过敏性结膜炎的发生...     

变应原制剂在变应性鼻炎诊治中的应用

目的探讨阿罗格变应原制剂在变应性鼻炎患者诊断和治疗中的临床价值.方法用20种阿罗格变应原进行皮肤点刺试验,以生理盐水为阴性对照,组胺为阳性对照.结果临床诊断为变应性鼻炎的653例患者中,粉尘螨、屋尘螨的阳性率分别为73.2%和71.4%,狗上皮为33.5%;其他17种变应原的阳性率分别为0.6%～56.9%,食物组以咖哩和小虾多见.阳性对照的阳性率为3.1%.选择螨类及其他变应原阳性的患者97例行脱敏治疗,94例显效.结论阿罗格变应原皮肤点刺试验可为诊断变应性鼻炎提供依据,并为特异性脱敏治疗提供客观指标,方便安全、操作简单、假阳性少、多种变应原可同时检测、特异性高.     

常年性变应性鼻炎的狗及猫上皮变应原点刺试验

目的 分析常年性变应性鼻炎的狗、猫上皮变应原皮肤点刺试验的阳性结果,对其他气传变应原的反应性,并进一步探讨环境接触与其相关性.方法 总结1 022例常年性变应性鼻炎患者采用阿罗格○ R17种气传变应原标准化试液进行的皮肤点刺试验;分析狗、猫上皮变应原的皮试结果及合并其他气传变应原阳性的比例;并根据是否有环境接触分类,比较各组在阳性率分布上的差异.结果 常年性变应性鼻炎中狗上皮变应原皮试阳性占13.80%,猫上皮阳性占6.95%;且98%以上合并其他气传变应原阳性,尤以合并粉尘螨、屋尘螨阳性居多.其中21.93%和26.32%环境接触狗/猫的变应性鼻炎相应狗/猫上皮变应原皮试阳性;无环境接触组的阳性率分别为12.78%和6.58%,差异均有统计学意义(P<0.01).结论 常年性变应性鼻炎的狗上皮及猫上皮的阳性率位居前列,其中绝大多数合并其他气传变应原阳性.鉴于环境接触对狗、猫上皮过敏的高危险性,变应性鼻炎患者应该尽可能地避免饲养、接触宠物.     

变应性鼻炎患者血清特异性IgE分析

目的 观察变应性鼻炎(allergic rhinitis,AR)患者46种常见变应原血清特异性IgE(SIgE)的阳性检出率,以及合并有哮喘和(或)特应性皮炎等个人过敏史对其阳性检出率的影响.方法 应用UniCAP100E免疫荧光定量分析系统检测80例AR患者SIgE.结果 AR患者粉尘螨、屋尘螨的SIgE阳性检出率分别为68.75%,67.50%;粉尘、屋尘检出率分别为41.25%,38.75%;昆虫类中飞蛾、蟑螂、蜂毒检出率分别为47.50%,38.75%,20.00%;垫料类中蚕丝、棉花检出率分别为31.25%,15.00%;花粉以苋科为主,检出率为18.75%;真菌类以交链孢霉、白色念珠菌、蠕孢霉、烟曲霉为主,检出率分别为13.75%,13.75%,12.50%,10.00%;猫、狗毛的检出率分别为12.50%,8.75%;食物以虾、蟹为主,检出率分别为38.75%,36.25%.合并哮喘和(或)特应性皮炎等个人过敏史的AR患者SIgE阳性检出率与无此病史的AR患者差异有统计学意义(P＜0.01).结论 螨、灰尘、昆虫、垫料、花粉、猫狗皮毛、部分真菌及食物虾、蟹是AR常见变应原;合并有哮喘和(或)特应性皮炎等个人过敏史AR患者SIgE阳性检出率明显高于无个人过敏史患者.     

变应性鼻炎891例变应原检测分析

目的 探讨上海市浦东新区变应性鼻炎患者的常见变应原种类,为变应性鼻炎的防治提供可靠的依据.方法 对891例变应性鼻炎患者行皮肤变应原点刺试验,变应原试剂由吸入组8种(霉菌、山羊皮、羽毛、杂草、动物毛、尘螨、悬铃木、花)和食物组4种(小虾、啤酒花、牛奶、鸡蛋)组成.结果 引起变应性鼻炎的变应原主要为吸入物,其次为食物.结论 变应原点刺试验有助于发现变应原,从而尽可能避免接触变应原,有条件者尚可进行脱敏治疗.     

745例变应性结膜炎的临床特点

背景 变应性结膜炎是临床上常见疾病,但由于不同类型变应性结膜炎常有伴随症状和变应性疾病,因此影响诊疗的正确性和及时性,全面了解变应性结膜炎的临床特点有助于其正确的诊断和治疗.目的 探讨各类变应性结膜炎的临床特点. 方法 采用描述性研究方法,对2011年4月至2015年3月于北京同仁眼科中心确诊和治疗的745例各类变应性结膜炎患者的临床资料进行回顾性分析,包括患者一般情况、病史、家族史、个人过敏史、用药史、角膜接触镜配戴史、病程、每次发作持续时间、症状加重和缓解因素、眼部以外的变应性疾病、眼部伴随疾病和症状以及裂隙灯显微镜下眼前节检查结果和治疗反应,总结患者的临床特点,并分析不同年龄与症状的关系.结果 745例患者中,包括季节性变应性结膜炎(SAC)和常年性变应性结膜炎(PAC) 562例,占75.44％;春季结膜炎(VKC) 163例,占21.88％;巨乳头性结膜炎(GPC) 18例,占2.42％;AKC 2例,占0.27％.变应性结膜炎7月份就诊者例数最多,为180例,占24.16％,12月份就诊者最少,为26例,占3.49％.变应性结膜炎眼部常见症状为眼痒(395例,占53.02％)、眼红(273例,占36.64％)、瞬目增多/揉眼(163例,占21.88％).≤14岁组患者434例,占58.26％,15 ～ 39岁组患者254例,占34.09％,≥40岁组患者57例,占7.65％;3个组间男女比例比较差异有统计学意义(x2=89.431,P=0.000);290例患者伴有眼部以外的变应性疾病,包括变应性鼻炎、湿疹、荨麻疹、变应性紫癜和哮喘.391例患者伴有其他眼部疾病,分别为干眼、屈光不正、睑缘炎和睑板腺功能障碍、角膜上皮病变、倒睫和前葡萄膜炎.Logistic回归分析发现,≤14岁组患者瞬目增多/揉眼症状为主诉者多于＞14岁组,差异有统计学意义(β=-2.039,P=0.000),而眼干涩、异物感、酸胀/痛为主诉者少于≤14岁组,差异均有统计学意义(β=1.585,P=0.001;β=1.174,P=0.003;β=1.218,P=0.037).所有患者均接受过双效药物或抗组胺药物、糖皮质激素或免疫抑制剂的局部治疗,均可缓解症状.结论 变应性结膜炎中以SAC/PAC多见,其次为VKC.变应性结膜炎以夏季高发,临床症状多样,同时可伴有其他眼病或眼部以外变应性疾病.双效药物或抗组胺药物、糖皮质激素或免疫抑制剂的局部应用是变应性结膜炎的常用治疗方法.     

过敏性结膜炎变应原检查

过敏性结膜炎是一种反复发作、双眼发生的变应性眼病 ,多见于儿童及青少年[1] 。我们将本院 1996年 8月至1999年 8月在我科就诊的 2 3例过敏性结膜炎青少年患者资料进行总结 ,旨在探讨过敏性结膜炎的常见变应原 ,分析引发过敏性结膜炎的变应原种类。1.资料与方法 :(1)对象 :1996年 8月至 1999年 8月因典型眼部症状就诊于我院变态反应门诊的青少年患者 2 3例 ,均根据文献 [1]方法确诊为过敏性结膜炎。其中男性 15例 ,女性 8例。年龄 4～ 18岁 ,平均 10 4 8岁。 4岁 1例 ,8～ 14岁12例 ,15～ 18岁 10例。病程 0 5～ 12 0年 ,平均 3 94年。(…     

富马酸酮替芬滴眼液治疗季节变应性结膜炎眼痒及结膜充血的疗效观察

目的 探讨0.025%富马酸酮替芬滴眼液治疗季节性变应性结膜炎患者眼痒、结膜充血的临床疗效.方法 采用多中心、双盲、随机、平行组别的研究方法,将诊断为季节性变应性结膜炎的229例(229只眼)患者随机分为试验组114例,给予进口0.025%富马酸酮替芬滴眼液,对照组115例,给予0.05%依美斯汀滴眼液,均为2次/d,每次1滴,疗程14d.在用药前和用药后(7±1)d,(14±1)d对两组患者的眼痒和结膜充血进行观察评分.结果 用药后(7±1)d以及(14±1)d,酮替芬组和依美斯汀组眼痒、结膜充血评分均明显下降,与基线期相比差异有统计学意义(P＜0.05);眼痒和结膜充血下降幅度组间(酮替芬一依美斯汀)差异无统计学意义(P＞0.05).结论 进口0.025%富马酸酮替芬滴眼液治疗季节性变应性结膜炎患者的眼痒、结膜充血疗效非劣效于0.05%依美斯汀滴眼液.     

江门地区儿童变应性鼻炎变应原临床分析

目的 了解江门地区变应性鼻炎患儿的变应原种类,为儿童变应性鼻炎的防治提供科学依据.方法 应用18种变应原点刺液对332例变应性鼻炎患儿进行皮肤点刺试验.结果 332例变应性鼻炎患儿中,变应原阳性率86.7％,2种或2种以上变应原阳性率56.6％;变应原阳性率前5位的是粉尘螨、蟑螂、海蟹、海虾、狗毛,分别为80.1％、34.6％、24.4％、18.7％、16.6％.随年龄增长,男女变应原阳性率及粉尘螨强阳性率均出现差异.结论 粉尘螨是江门地区变应性鼻炎患儿的首要变应原,明确变应原后对变应性鼻炎的预防及特异性免疫治疗具有重要指导意义.     

The value of the cytological exam in the diagnosis of allergic conjunctivitis

Cytologic investigations was performed in four groups of patients: central group (10 cares), without pathologic lesions; 12 patients were admitted with allergic conjunctivitis (with positive allergy tests, atopic state or clinical manifest allergic diseases), 20 cases with bacterial conjunctivitis; 8 cases with mix allergic and bacterial conjunctivitis (that hardly respond to therapy). Smears from the conjunctivae secretion were air-dried and stained with blue-polycrometanin Dr?gan method. Cytologic lesions characteristic for each group of patients are described. Our results suggest that cytology from the conjunctivae secretion is helpful in the diagnosis of the allergic etiology; also, it accurately the allergic components mix conjunctivitis.     

Clinical trial of the topical use of disodium cromoglycate in vernal, allergic and chronic conjunctivitis

Thirty-three patients were treated with disodium cromoglycate (DSCG). Of these 5 had vernal conjunctivitis, 18 had allergic conjunctivitis and 10 had mild chronic conjunctivitis in which the exact aetiology could not be determined. 70% of patients with DSCG as the only medication achieved at least some beneficial effect being almost exclusively in the groups of either vernal or allergic conjunctivitis. The basic trend seemed to indicate a reduction in severity during the treatment with DSCG in allergic diseases.     

Allergic conjunctivitis and contact lenses: experience with olopatadine hydrochloride 0.1% therapy

OBJECTIVE: The efficacy of Patanol, a topically applied anti-allergic agent, was evaluated in a group of patients with allergic conjunctivitis due to contact lens wear (GROUP I) and a group comprised of seasonal allergic conjunctivitis patients, vernal conjunctivitis patients and atopic keratoconjunctivitis patients (GROUP II). METHODS: One drop of Patanol was administered to each eye twice daily. Signs and symptoms were assessed 7, 14, and 28 days after initiation of drug therapy. RESULTS: Itching/burning, tearing, hyperemia and papillary reaction were reduced to scores of 0/1 (absent/mild) in 85%, 90%, 81% and 62%, respectively, of GROUP I patients at Day 28. The allergic conditions in GROUP II patients also improved with Patanol treatment. Itching/burning, tearing, hyperemia and papillary reactions were absent/mild in 60%, 76%, 96% and 90%, respectively, of these patients at Day 28. CONCLUSION: Patanol treatment effectively and rapidly alleviated the signs and symptoms of allergic conjunctivitis due to contact lens wear as well as vernal conjunctivitis, atopic keratoconjunctivitis and the common seasonal allergic conjunctivitis. Patanol allowed allergic patients to be more comfortable while permitting them to continue using contact lenses.     

Bilateral conjunctival mucosa-associated lymphoid tissue lymphoma misdiagnosed as allergic conjunctivitis

PURPOSE: This report aimed to discuss two nearly identical cases of primary conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma mimicking allergic conjunctivitis. METHODS: Two patients were referred for intractability to conventional treatment of initial diagnoses of allergic conjunctivitis. On ocular examination, normally pigmented, giant papilla-like lesions were found bilaterally in the upper conjunctiva. Excisional biopsies were performed. RESULTS: Histopathologic and immunohistochemical examination of the conjunctival biopsies indicated MALT lymphoma in both patients. The patients subsequently received radiation therapy and achieved complete remission with no evidence of recurrence during follow-up periods of 13 and 11 months. CONCLUSION: Conjunctival low-grade lymphoma may share similar clinical features with allergic conjunctivitis. Ophthalmologists should be concerned that primary conjunctival low-grade malignant lymphoma can be misdiagnosed as allergic conjunctivitis     

Quantitative determination of histamine in tears during conjunctivitis by a novel HPLC method

The histamine content of tears of healthy sex- and age-matched subjects and patients affected by allergic or nonallergic inflammatory ocular diseases was determined through a new competitive reverse-phase high-performance liquid chromatography (HPLC) method. Tear samples from 50 healthy subjects, 30 patients affected by seasonal allergic conjunctivitis, 12 patients with bacterial conjunctivitis associated with Haemophilus influenzae and 8 patients with bacterial conjunctivitis associated with Streptococcus pneumoniae were analyzed for histamine concentration by O-phthaldialdehyde precolumn derivatization-based HPLC. In physiological conditions, the tear histamine content was low (2.26 ng/ml) and did not vary in relation to age and sex. Histamine levels were significantly higher in all the patients studied, to a greater extent in those affected by allergic (23.61 ng/ml) or Haemophilus influenzae-associated (21.53 ng/ml) conjunctivitis.     

Correlations between allergen-specific IgE serum levels in patients with allergic conjunctivitis in spring

Purpose: The purpose of this study was to evaluate the relation between various specific class E immunoglobulins (IgE) in serum and allergic conjunctivitis in spring. Methods: Forty patients with allergic conjunctivitis and fifty healthy volunteers were selected for this trial. Total IgE and specific IgE to twelve inhalant allergens were measured using the CAP system. Results: Specific IgE levels caused by cedar and cypress pollen, house dust, Dermatophagoides pteronyssinus , acarus, and moth allergens were higher in the allergy group than in the control group. No correlation was proven between the specific IgE levels and the total IgE level. The highest positivity rate for a specific allergen in patients with allergic conjunctivitis was 52.5% for cedar pollen, followed by cypress pollen at 37.5%. Conclusions: These results suggest that cypress pollen was the largest cause of allergic conjunctivitis and that the total IgE level had no correlation with each specific IgE.     

Relation Between Total Tear IgE and Severity of Acute Seasonal Allergic Conjunctivitis

Purpose: Measurement of total tear immunoglobulin E (IgE) is useful for the diagnosis of allergic conjunctivitis, but it is still unknown whether measurement of total tear IgE is useful for assessment of the severity of allergic conjunctivitis. We evaluated the relation between the total IgE level in tears and objective signs of allergic conjunctivitis. Methods: A prospective, nonrandomized, and cross-sectional study was conducted in 84 patients with allergic conjunctivitis (allergic group) and 80 age- and sex-matched healthy control subjects (control group). The total tear IgE score was obtained with the Allerwatch(?) test (0, 1, and 2), and ten severity scores (0, 1, 2, 3) were determined for objective ocular findings of the palpebral and bulbar conjunctiva, as well as limbal and corneal lesions. Results: The scores for total tear IgE and each of the objective ocular findings were higher in the allergic group than in the control group (all p < 0.01). The total tear IgE score was correlated with the severity of each clinical feature of allergic conjunctivitis (p < 0.01), except for corneal epithelial damage in the allergic group. Multivariate analysis revealed that the severity of giant papillae was the most important indicator of the total tear IgE score (odds ratio = 1.33, p < 0.00001). Conclusion: The total tear IgE score was correlated with the scores for objective signs of allergic conjunctivitis. This rapid test for total IgE in tear fluid is easy to perform and could be used to assess the severity of allergic conjunctivitis on an outpatient basis.