過(guo)敏性鼻(bi)炎是非(fei)常常見(jian)的一種疾病,我國兒(er)童(tong)過(guo)敏性鼻(bi)炎的患病率約為10%,由于工(gong)業化發展,空氣質(zhi)量的惡(e)化,過(guo)敏性鼻(bi)炎呈繼續增加趨勢。過(guo)敏性鼻(bi)炎最常見(jian)的表現是打(da)噴嚏、流(liu)清水(shui)樣鼻(bi)涕、鼻(bi)子癢和鼻(bi)塞,部分人表現為嗅覺減退。其實過(guo)敏性鼻(bi)炎是鼻(bi)腔(qiang)黏膜接觸過(guo)敏原后發生的過(guo)度的自我防御(yu)反應,只要過(guo)敏原存在,就(jiu)無(wu)法斷(duan)根(gen),所以是一種慢性疾病。
過敏(min)性(xing)鼻(bi)炎和哮喘之間有沒有關系(xi)?
不(bu)僅(jin)有(you)(you)關系,而(er)且關系很(hen)大(da),40% 的(de)過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎患者(zhe)可(ke)合并哮喘(chuan)(chuan)(chuan)(chuan),表現(xian)為(wei)反(fan)復發(fa)作的(de)喘(chuan)(chuan)(chuan)(chuan)息、咳嗽(sou)、氣急和(he)胸(xiong)悶。鼻(bi)腔和(he)氣管(guan)支(zhi)氣管(guan)其(qi)實是(shi)同(tong)(tong)(tong)一(yi)(yi)(yi)(yi)(yi)氣道,過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎和(he)哮喘(chuan)(chuan)(chuan)(chuan)一(yi)(yi)(yi)(yi)(yi)樣(yang)是(shi)因(yin)(yin)為(wei)過(guo)(guo)敏(min)(min)(min)體質遇到外界過(guo)(guo)敏(min)(min)(min)原刺激(ji)下(xia)(xia)(xia)誘發(fa)的(de)I型變態性(xing)(xing)反(fan)應,兩(liang)者(zhe)具有(you)(you)相同(tong)(tong)(tong)的(de)病因(yin)(yin)。過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎發(fa)作的(de)時候,鼻(bi)腔分泌物向下(xia)(xia)(xia)流也可(ke)能刺激(ji)下(xia)(xia)(xia)呼(hu)(hu)吸道,誘發(fa)哮喘(chuan)(chuan)(chuan)(chuan)。在(zai)臨床(chuang)上有(you)(you)些(xie)患者(zhe)以(yi)過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎為(wei)主而(er)哮喘(chuan)(chuan)(chuan)(chuan)未確診或處于亞臨床(chuang)狀態,另一(yi)(yi)(yi)(yi)(yi)些(xie)病人則可(ke)兩(liang)種疾(ji)病同(tong)(tong)(tong)時存在(zai)。因(yin)(yin)此出現(xian)一(yi)(yi)(yi)(yi)(yi)個新的(de)醫(yi)學術(shu)語--過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎哮喘(chuan)(chuan)(chuan)(chuan)綜合癥,簡稱CARAS。在(zai)一(yi)(yi)(yi)(yi)(yi)定(ding)程度上其(qi)實是(shi)同(tong)(tong)(tong)一(yi)(yi)(yi)(yi)(yi)個疾(ji)病在(zai)上呼(hu)(hu)吸道和(he)下(xia)(xia)(xia)呼(hu)(hu)吸道的(de)不(bu)同(tong)(tong)(tong)表現(xian)。持續過(guo)(guo)敏(min)(min)(min)性(xing)(xing)鼻(bi)炎是(shi)哮喘(chuan)(chuan)(chuan)(chuan)的(de)獨立危險(xian)因(yin)(yin)素,甚至在(zai)沒(mei)有(you)(you)任何其(qi)他(ta)特應征(zheng)兆的(de)情況下(xia)(xia)(xia)。
老(lao)年婦女窒(zhi)息和持有哮(xiao)喘(chuan)噴霧
對(dui)于過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)患(huan)者(zhe)如(ru)果(guo)伴有(you)下(xia)呼吸道(dao)癥狀(zhuang),應進行氣道(dao)反(fan)(fan)應性(xing)(xing)(xing)測(ce)定和(he)(he)支氣管擴張試驗來(lai)判(pan)斷是否同(tong)時(shi)(shi)伴有(you)哮(xiao)喘。所(suo)有(you)懷(huai)疑過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)-哮(xiao)喘綜(zong)合癥的患(huan)者(zhe)在有(you)條件時(shi)(shi)均應檢查特異性(xing)(xing)(xing)免疫診斷試驗,用來(lai)判(pan)斷過(guo)(guo)(guo)(guo)敏(min)原種類(lei)和(he)(he)對(dui)過(guo)(guo)(guo)(guo)敏(min)原的過(guo)(guo)(guo)(guo)敏(min)程度。過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)能否發展(zhan)為哮(xiao)喘,與(yu)接觸過(guo)(guo)(guo)(guo)敏(min)原的數量和(he)(he)濃度有(you)密切關(guan)(guan)系,同(tong)時(shi)(shi)與(yu)患(huan)者(zhe)體質也(ye)有(you)一定關(guan)(guan)系。過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)哮(xiao)喘綜(zong)合癥一般分為三個階段:1.單純過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan),不伴氣道(dao)高(gao)(gao)反(fan)(fan)應性(xing)(xing)(xing)也(ye)無哮(xiao)喘;2.過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)伴有(you)氣道(dao)高(gao)(gao)反(fan)(fan)應性(xing)(xing)(xing),但無哮(xiao)喘癥狀(zhuang);3.過(guo)(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)鼻炎(yan)(yan)伴有(you)哮(xiao)喘和(he)(he)氣道(dao)高(gao)(gao)反(fan)(fan)應性(xing)(xing)(xing)。
elderly man with flu inhalation
對伴有(you)過敏(min)性(xing)(xing)鼻(bi)(bi)炎的哮喘(chuan)患者來(lai)講,積極(ji)治(zhi)療(liao)鼻(bi)(bi)炎可以顯著減少哮喘(chuan)病人急性(xing)(xing)發作次數和(he)住院的次數。治(zhi)療(liao)上(shang)以聯合(he)抗(kang)炎為主,經(jing)鼻(bi)(bi)吸(xi)入經(jing)上(shang)、下(xia)呼吸(xi)道的聯合(he)糖(tang)皮質激(ji)素治(zhi)療(liao)、抗(kang)組胺藥物治(zhi)療(liao)、變應(ying)原疫(yi)苗(miao)治(zhi)療(liao)和(he)全身免疫(yi)治(zhi)療(liao)。同(tong)一(yi)個氣道,同(tong)一(yi)種疾病,要重視(shi)過敏(min)性(xing)(xing)鼻(bi)(bi)炎早期(qi)預(yu)防(fang),也(ye)要重視(shi)過敏(min)性(xing)(xing)鼻(bi)(bi)炎和(he)哮喘(chuan)的同(tong)時(shi)防(fang)治(zhi)。
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