14高反应性鼻炎试题.pptVIP

* * * * The prevalence of asthma and rhinitis varies all over the world with allergic rhinitis being two times more prevalent than asthma. In countries with a more rural tradition the numbers are usually lower than in countries with a higher level of urbanisation. * This is the self-reported prevalence of the allergic rhinitis from eleven cities throughout the mainland of China and the average is 12.4%.The high prevalence have induced attention of related ministry of China government. * * * * Immediate hypersensitivity skin tests are used to demonstrate an IgE mediated reaction. A drop of allergen solution is placed on the skin and introduced into the epidermis by a sterile needle or stylette, by a light puncture of the skin. Positive and negative comparator tests using histamine and saline can be performed to prove that the skin is capable of demonstrating a positive reaction, and to prevent the interpretation of false-positive results occurring as a result of dermatographism. A positive wheal 3mm diameter reaction indicates that the patient is producing IgE antibodies to a specific allergen, and taken in conjunction with a positive history, is evidence that the allergen is responsible for the patient’s symptoms. Explanation of SPT result Positive Notable :may see nearly 25% in normal Emphasizing: corresponding with history information: Yes—— make diagnosis No—— may predictive Negative exclude drug effect unknow allergen may present non allergic Serum Specific IgE sIgE Specific IgE immunoassays may be used : extensive skin disease, skin test suppressive therapy antihistamines that cannot be discontinued, uncooperative patients, or when the history suggests an unusually high risk of anaphylaxis from skin testing. Positive results of testing specific IgE must be correlated with history and physical findings to assess their clinical Significance Generally, sensitivety and specificity of SPT is superior to testing of serum specific I