本文選題：變應(yīng)性鼻炎　切入點(diǎn)：鼻灌洗　出處：《南京大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：背景及目的 1997年Grossman首先明確提出“同一氣道,同一疾病”的論點(diǎn),強(qiáng)調(diào)上下呼吸道炎癥性疾病整體性的概念。2001年世界衛(wèi)生組織編寫(xiě)出版的指導(dǎo)性文件“變應(yīng)性鼻炎及其對(duì)哮喘的影響”(allergic rhinitis and its impact on asthma, ARIA)指出變應(yīng)性鼻炎是導(dǎo)致哮喘的主要因素之一,ARIA2008年修訂本更加明確闡述“變應(yīng)性鼻炎與哮喘是一個(gè)綜合征在呼吸道兩個(gè)部分的表現(xiàn)”這一基本觀點(diǎn),可見(jiàn)將二者作為整體進(jìn)行研究具有重要意義。因此,上下呼吸道之間氣道炎癥一致性和相關(guān)性的課題一直是近幾年研究的熱點(diǎn)。本研究通過(guò)對(duì)變應(yīng)性鼻炎患者與健康對(duì)照組鼻與下氣道炎癥指標(biāo),以及變應(yīng)性鼻炎患者鼻與下氣道炎癥指標(biāo)的對(duì)照研究,進(jìn)一步探討上、下呼吸道變應(yīng)性炎癥相關(guān)性,從而為更深入的基礎(chǔ)和臨床研究提供參考。 方法 將有典型變應(yīng)性鼻炎臨床癥狀和體征的病人按照過(guò)敏原皮膚點(diǎn)刺實(shí)驗(yàn)結(jié)果陽(yáng)性診斷為變應(yīng)性鼻炎,選擇高校就讀的健康學(xué)生及到本院體檢中心體檢的健康成人作為健康對(duì)照組,其中變應(yīng)性鼻炎組53例,健康對(duì)照組50例。所有入選者均行血常規(guī)檢查、鼻灌洗液和誘導(dǎo)痰炎癥細(xì)胞分類計(jì)數(shù)、鼻激發(fā)、支氣管激發(fā)試驗(yàn)。按照變應(yīng)性鼻炎患者組與健康對(duì)照組兩組各參數(shù)進(jìn)行比較,分析變應(yīng)性鼻炎組與正常組的檢查指標(biāo)是否有差異；將變應(yīng)性鼻炎組組內(nèi)各參數(shù)進(jìn)行比較,分析變應(yīng)性鼻炎患者鼻部與下氣道相關(guān)性。 結(jié)果 一、變應(yīng)性鼻炎患者與健康對(duì)照組鼻與下氣道炎癥指標(biāo)研究結(jié)果 1.變應(yīng)性鼻炎組鼻灌洗液嗜酸性粒細(xì)胞(eosinophil, EOS)比例(7.93±7.15)及誘導(dǎo)痰EOS比例(3.49±4.25)均高于健康對(duì)照組鼻灌洗液EOS(0.72±0.71)及誘導(dǎo)痰EOS比例(1.33±1.08),差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。 2.變應(yīng)性鼻炎組患者鼻激發(fā)的陽(yáng)性率及支氣管激發(fā)陽(yáng)性率均明顯高于正常組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。 二、變應(yīng)性鼻炎患者組鼻與下氣道炎癥指標(biāo)研究結(jié)果 1.變應(yīng)性鼻炎組鼻灌洗液EOS比例與誘導(dǎo)痰EOS比例呈正相關(guān)(r=0.385,P=0.04)。 2.變應(yīng)性鼻炎組鼻激發(fā)陽(yáng)性率與支氣管激發(fā)陽(yáng)性率無(wú)相關(guān)性(r==0.143,P=0.308)。 3.變應(yīng)性鼻炎組以支氣管激發(fā)陰、陽(yáng)分組兩組間誘導(dǎo)痰EOS比例存在差異(P0.05),而兩組間鼻灌洗液EOS比例無(wú)差異(P0.05)。 4.變應(yīng)性鼻炎組以鼻激發(fā)陰、陽(yáng)分組兩組間鼻灌洗液EOS比例存在差異(P0.05),而兩組間誘導(dǎo)痰EOS比例無(wú)差異(P0.05)。 5.變應(yīng)性鼻炎組鼻灌洗液EOS比例與誘導(dǎo)痰EOS比例以及血常規(guī)中EOS比例均有相關(guān)性(P0.05)。 結(jié)論 1.變應(yīng)性鼻炎組病人與正常對(duì)照組比較,鼻與下氣道炎癥均明顯增高。 2.變應(yīng)性鼻炎組病人鼻與下氣道炎癥具有一致性。 3.鼻與下氣道以及血常規(guī)的嗜酸性粒細(xì)胞具有高度相關(guān)性,提示變應(yīng)性鼻炎是一種局部炎癥與全身炎癥共存的變態(tài)反應(yīng)性疾病。 4.下氣道嗜酸粒細(xì)胞性炎癥可能是支氣管高反應(yīng)性的原因。
[Abstract]:Background and purpose
1997 Grossman first explicitly put forward the "one airway, one disease" argument, emphasizes on the concepts of.2001 lower respiratory tract inflammatory disease of the whole year WHO published the guidance document "allergic rhinitis and its impact on asthma" (allergic rhinitis and its impact on asthma, ARIA) pointed out that allergic rhinitis is one of the the main factors that lead to asthma, ARIA2008 revised more clearly "allergic rhinitis and asthma is a syndrome in two parts of the respiratory tract" this basic viewpoint, the two were visible for the whole study has important significance. Therefore, between the upper and lower respiratory tract inflammation consistency and correlation research has been a research hotspot in recent years. Based on the control group and the nasal airway inflammation in patients with allergic rhinitis and health, and patients with allergic rhinitis A comparative study of nasal and lower airway inflammatory indexes will further explore the correlation between upper and lower respiratory tract allergic inflammation, so as to provide a reference for further in-depth basic and clinical research.
Method
There will be a typical allergic rhinitis clinical symptoms and signs of patients with allergic rhinitis in accordance with allergen skin prick test results positive diagnosis, healthy students choose to attend college and to the health of adults from medical examination center as a healthy control group, the allergic rhinitis group 53 cases, 50 cases of healthy control groups. In all the subjects. Underwent blood routine examination, nasal lavage and induced sputum inflammatory cell counts, nasal provocation, bronchial provocation test in patients with allergic rhinitis group and healthy control group of two groups of parameters were compared, analysis indexes of allergic rhinitis group and normal group whether there are differences; each parameter in allergic rhinitis group by comparison, correlation analysis of patients with allergic rhinitis and nasal airway.
Result
The results of nasal and lower airway inflammation in patients with allergic rhinitis and healthy controls
1. in the allergic rhinitis group, the proportion of eosinophil (EOS) in nasal lavage fluid (7.93 + 7.15) and the ratio of EOS in induced sputum (3.49 + 4.25) were all higher than those in healthy control group, EOS (0.72 + 0.71) and sputum sputum EOS ratio (1.33 + 1.08), the difference was statistically significant (P0.05).
2. the positive rate of nasal excitation and the positive rate of bronchial provocation in the patients with allergic rhinitis were significantly higher than those in the normal group, and the difference was statistically significant (P0.05).
Two, research results of nasal and lower airway inflammation in patients with allergic rhinitis
There was a positive correlation between the ratio of EOS and the proportion of induced sputum EOS in 1. allergic rhinitis group (r=0.385, P=0.04).
There was no correlation between the positive rate of nasal excitation and the positive rate of bronchial provocation in 2. allergic rhinitis group (r==0.143, P=0.308).
In 3. allergic rhinitis group, the ratio of induced sputum EOS in the two groups was different (P0.05), but there was no difference in the proportion of EOS between the two groups (P0.05).
In 4. allergic rhinitis, the proportion of EOS in the two groups was different (P0.05), but there was no difference in the proportion of EOS between the two groups (P0.05).
In 5. allergic rhinitis, the proportion of EOS in nasal lavage fluid was correlated with the proportion of induced sputum EOS and the proportion of EOS in blood routine (P0.05).
conclusion
1. patients with allergic rhinitis were significantly higher in nasal and lower airway inflammation compared with the normal control group.
2. the nasal and lower airway inflammation in the patients with allergic rhinitis is consistent.
3., nose is highly correlated with lower airway and blood routine eosinophils, suggesting allergic rhinitis is an allergic disease with local inflammation and systemic inflammation.
4. the eosinophilic inflammation in the lower airway may be the cause of bronchial hyperreactivity.

【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R765.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 李澤卿;陳峰;江滿杰;吳昆e，

本文編號(hào)：1578439