14高反应性鼻炎医学课件.pptVIP

耳鼻咽喉头颈外科学

耳鼻咽喉头颈外科学第二篇鼻科学及颅面疾病（3）

第十一章

鼻黏膜高反应性鼻病

第一节

变态反应性鼻炎

RespiratorymucosainnoseThenasalmucosashowedbytransmi-ssionalelectromi-Croscope.

Thepictureofnormalmucosashowedbynasalendoscope

Nasalhyper-reactivityNasalcavity:FirstlineofairwaySensitivity:richnervedistributionMucosalcompound:respiratoryepithelialcellsGobletcellglands(serousormucous)richvessels

Immunecompound:Toll-likereceptorslymphocytes(T,B)serouscellsmastcellsepithelialcells

ResponseofnoseinducedbysomefactorsChallengefactors:enviromentalWeather、temperature、humidityinhalants:Dust、allergen、chemicalspollutionmostofabove

Intrinsic:nervous、stressordisappoint、depressoranxious

Nasalresponse——Protective

hyper-reactivityofNasalmucosaThedifferenceofnasalmucosalreactionbetweenphysiologicandpathologiccondition

高反应性鼻病Definition：HyperreactiveRhinopathyissymptomicdisorderandthereactionofnasalmucosainducedbystimuliexceednormallimit

Mainincluding:AllergicRhinitisNon-allergicrhinitis——coldairinducingrhinitisendocrinerhinitisdruginducingrhinitisnonallergicallergicrhinitiswitheosinophiliavasomotorrhinitis(idiopathicrhinitis)

Allergicrhinitis

AllergicrhinitisisasymptomaticdisorderofthenoseinducedafterallergenexposurebyanimmunoglobulinE(IgE)-mediatedinflammationofthemembranesliningthenoseDifinitionofAllergicrhinitis

KeypointofthedifinitionSusceptibleindividualInducedbyallergenexposureIgEmediatedmainlyNasalmucosainfalmmationMainsymptomsincludesneeze,rhinorrheaandobstruction

allergenPollen:tree,grass,cropplant

fugi

dustmite

petdander

Mechanismofallergicinflammation-Th2response

Th2BIL-4变应原NaiveThIgEIL-4IL-5释放炎症介质毒性蛋白细胞因子释放炎症介质和细胞因子Eo变应性鼻炎免疫学机制－以Th2反应为主的免疫性疾病嗜酸性粒细胞肥大细胞和嗜碱性粒细胞速发反应（EarlyPhaseReaction）迟发反应（LatePhaseReaction）抗原提呈细胞

SymptomsNasalobstructionSymptoms1hrdaylyLa