从花粉症看过敏性疾病的整体诊疗策略

doi:10.6040/j.issn.1673-3770.1.2018.041

山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (1): 13-19.doi: 10.6040/j.issn.1673-3770.1.2018.041

从花粉症看过敏性疾病的整体诊疗策略

关凯^1,^2,*(),王良录^1,²

1. 中国医学科学院北京协和医学院北京协和医院变态(过敏)反应科，北京 100730
2. 过敏性疾病精准诊疗研究北京市重点实验室，北京 100730

收稿日期:2018-11-19 出版日期:2019-01-20 发布日期:2019-01-28
通讯作者: 关凯 E-mail:dr_guankai@126.com
作者简介:关凯，男，医学博士，副主任医师，副教授，硕士生导师，中国医学科学院北京协和医院过敏性疾病精准诊疗研究北京市重点实验室主要研究者(PI)。主要学术任职：中华医学会变态反应学分会工作秘书及过敏原特异性诊断与免疫治疗学组委员，中国医师协会变态反应医师分会青年委员会副主任委员,亚太医学生物免疫学会儿童过敏免疫风湿病分会常务委员，世界中医药学会联合会蜂疗专业委员会常务理事，中国中药协会中药注射剂研究发展专业委员会委员兼药物警戒与安全研究组核心专家，北京医师协会变态反应专科医师分会理事兼总干事、北京医师协会变态反应科专家委员会委员兼秘书长，中国医疗保健国际交流促进会健康科普分会委员，北京中西医结合学会环境与健康专业委员会委员。《中华临床免疫和变态反应杂志》《山东大学耳鼻喉眼学报》编委，《中华医学百科全书》变态反应学卷编委。以第一/通信作者发表学术文章近30篇(含4篇SCI)，主持北京自然科学基金等项目3项；参编、参译学术著作4部。擅长上下呼吸道过敏性疾病(过敏性鼻炎、过敏性咳嗽、过敏性哮喘)、食物过敏、药物过敏、昆虫(蜂毒)毒液过敏、过敏性休克、特应性皮炎等的诊治工作。在蜂毒致严重过敏反应领域的学术研究居国内领先，曾多次在国际会议上就该领域研究进展进行大会发言
基金资助:
北京自然科学基金面上项目(7172179);北京协和医学院青年教师培养项目(2015zlgc0726)

Overall diagnosis and treatment strategy for allergic diseases related to hay fever

Kai GUAN^1,^2,*(),Lianglu WANG^1,²

1. Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2. Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China

Received:2018-11-19 Online:2019-01-20 Published:2019-01-28
Contact: Kai GUAN E-mail:dr_guankai@126.com
Supported by:
北京自然科学基金面上项目(7172179);北京协和医学院青年教师培养项目(2015zlgc0726)

摘要/Abstract

摘要：

花粉症是指具有特应性遗传素质的个体吸入致敏花粉后，由特异性免疫球蛋白E(specific Immunoglobulin E, sIgE)介导的非特异性炎症反应及其引发的以变应性结膜炎、鼻炎、哮喘为主的一系列临床症状，其症状具有明显的时间性和地区性，并且易受某些气象因素的影响。引发花粉症的常见致敏花粉包括春季树木花粉，夏季牧草花粉和秋季杂草花粉，在中国北方地区花粉症患者发病时生活质量明显差于尘螨过敏患者，杂草花粉比树木花粉更易诱发哮喘。花粉症的诊断步骤包括病史采集、变应原特异性诊断测量(皮肤试验和血清sIgE检测)、病史与检测结果相关性分析；临床管理原则包括变应原回避，变应原特异性免疫治疗，抗炎药物治疗(例如糖皮质激素、H1抗组胺药物、白三烯受体拮抗剂)。临床经验表明，使用协和花粉变应原制剂诊断准确度高，免疫治疗疗效及安全性均佳，且能有效地阻止过敏性鼻炎发展为哮喘并防止出现新的致敏原，停止治疗后亦具有一定的持续性。

关键词: 花粉症, 变应原特异性诊断, 免疫治疗

Abstract:

Pollinosis refers to a series of clinical symptoms, such as allergic conjunctivitis, rhinitis, and asthma, that are mediated by specific immunoglobulin E (sIgE) after inhalation of allergic pollens by atopic individuals. The clinical symptoms of pollinosis depend on the season, region, and climate. Common pollens causing pollinosis come from trees, grass, and weeds. In northern China, the quality of life for patients with pollinosis is significantly worse than that for the patients with dust mite allergy. The weed pollen is more likely to induce asthma than the tree pollen. The diagnostic steps for pollinosis include anamnesis, allergen-specific diagnostic tests (skin test and serum sIgE test), and result assessment. Clinical management includes allergen avoidance, allergen-specific immunotherapy, and anti-inflammatory medicines (such as glucocorticoids, H1 antihistamines, and leukotriene receptor antagonists). Clinical data showed that the pollen extracts from the PUMCH Allergen Products Manufacturing and Research Center are particularly useful in the diagnosis of pollinosis. They have good efficacy and safety, and can prevent allergic rhinitis from developing into asthma and inhibit the emergence of reactions to new allergens effectively. Treatment efficacy can be maintained even after stopping active administration.

Key words: Pollinosis, Allergen specific diagnosis, Immunotherapy

中图分类号:

R392.8

关凯,王良录. 从花粉症看过敏性疾病的整体诊疗策略[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 13-19.

Kai GUAN,Lianglu WANG. Overall diagnosis and treatment strategy for allergic diseases related to hay fever[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 13-19.

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从花粉症看过敏性疾病的整体诊疗策略

Overall diagnosis and treatment strategy for allergic diseases related to hay fever

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