小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 鼻塞
- 鼻后滴漏
- 鼻溢(流涕)
- 咽痛
其他诊断因素
- 耳堵塞感
- 鼻窦源性头痛
- 由姿势变化引发
- 无发热
- 喷嚏
- 脓性分泌物
- 双侧症状
- 鼻窦痛
危险因素
- 发病年龄> 35 岁
- 没有季节性症状
- 猫没有使症状加重
- 暴露于香水
- 暴露于烟雾(例如:木柴、烟草)
- 暴露于发胶
- 暴露于罐装香料
- 温度的变化
- 气压变化
- 无家族过敏史
- 高雌激素状态
- β-受体阻滞剂的使用
- 滴鼻剂滥用
诊断性检查
首要检查
- 变应原皮肤点刺试验
- 血清特异性 IgE 检测
需考虑的检查
- 鼻嗜酸性粒细胞涂片
- 鼻窦计算机体层成像
- 鼻内镜检查
- 鼻内激发试验
治疗流程
间歇性
持续性
撰稿人
作者
Jonathan A. Bernstein, MD
Professor of Clinical Medicine
Department of Internal Medicine
Division of Immunology/Allergy Section
University of Cincinnati College of Medicine
Cincinnati
OH
利益声明
JAB is a principal investigator, consultant, and speaker for Sanofi Regeneron, Novartis, Genentech, and AstraZeneca. JAB is a sub-principal investigator and speaker for GSK, a principal investigator and consultant for Merck, and a consultant and speaker for Optinose. JAB is a secretary treasurer for the American Academy of Allergy, Asthma, and Immunology (AAAAI), and a Vice Chairman of the AAAAI Foundation. JAB is on the board of directors for the World Allergy Organization, is an advisory board member for the US Hereditary Angioedema Association, is a member of the executive board for Interasma, and is Chairperson for Allergists for Israel. JAB is an author of a number of references cited in this topic.
鸣谢
Professor Jonathan A. Bernstein would like to gratefully acknowledge Dr Chris Codispoti, a previous contributor to this topic.
利益声明
CC declares that he has no competing interests.
同行评议者
Elisabeth E. Adderson, MD
Associate Member
St. Jude Faculty Director
Pediatric Infectious Diseases Fellowship Program
Memphis
TN
利益声明
EEA declares that she has no competing interests.
Ozgur Yigit, MD
Chief
ENT Department
Istanbul Training and Research Hospital
Istanbul
Turkey
利益声明
OY declares that he has no competing interests.
鉴别诊断
- 变应性鼻炎(季节性、常年性、混合性)
- 鼻息肉病
- 鼻中隔偏曲
更多 鉴别诊断指南
- 2020 年鼻炎:实践参数更新
- 英国变态反应与临床免疫学会 (BSACI) 对变应性和非变应性鼻炎的诊断和治疗指南
更多 指南- 登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
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