小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 喷嚏
- 鼻痒
其他诊断因素
- 腭、喉、耳以及眼痒
- 眼睛红、眼袋以及流泪
- 疲乏和易激惹
- 鼻塞
- 鼻溢（流涕）
- 变应性黑眼圈
- 结膜充血
- 眼部黏液分泌
- 鼻上褶皱
- 鼻黏膜苍白
- 鼻黏膜和鼻甲肿胀
- 大量的鼻分泌物
- Dennie-Morgan 线（下眼睑下折痕）
危险因素
- 其他特应性疾病或特应性家族史
- 年龄< 20 岁
- 气源性致敏原（花粉、霉菌、屋尘螨、污染）暴露
- 动物毛屑暴露
- 种族
- 变应原皮肤点刺试验阳性
诊断性检查
首要检查
- 抗组胺或者鼻内皮质类固醇试验性治疗
需考虑的检查
- 变应原皮肤点刺试验
- 体外特异性 IgE 检测
治疗流程
轻度或间歇性症状
持续性中至重度症状
常规治疗无效或耐受性差
撰稿人
作者
Gary C. Steven, MD, PhD, CPI, FAAAAI, FACAAI, FAPCR
Medical Director
American Academy of Allergy, Asthma & Immunology Registry
Assistant Clinical Professor of Medicine
Medical College of Wisconsin
Adjunct Clinical Instructor
College of Nursing
University of Wisconsin-Milwaukee
Allergy, Asthma & Sinus Center
Milwaukee
WI
利益声明
GCS has taken part in sponsored research for the ALK clinical trial of the house dust mite SLIT tablet for use in paediatric patients. He is a member of the Joint Task Force on Practice Parameters Workgroup on the Allergic Rhinitis Practice Parameter.
鸣谢
Dr Gary C. Steven would like to gratefully acknowledge Dr Alexander Greiner, a previous contributor to this topic.
利益声明
AG has received grant/research support from: AstraZeneca; Boehringer Ingelheim; Cephalon Circassia Ltd; Clement Clarke Cytos biotechnology; GlaxoSmithKline; Glenmark Specialty, S.A.; Hoffman-LaRoche/Genentech; HRA/Novartis; Janssen Research & Development; Kalypsys , Inc.; Lupin; Merck; Mylan Pharmaceuticals, Inc.; Nestle (Nestec Ltd); Novartis Ono Pharmaceutical Co., Ltd.; Perrigo; Rigel Pharmaceuticals, Inc.; Roxane Laboratories Inc.; Shionogi Inc.; Sunovion TEVA Branded Pharmaceutical Products; UBC (United Biosource Corporation)/Amgen Pharmaceuticals; and sponsorship for pharmaceutical trials from Allergen Research Corporation/Aimmune Therapeutics, Inc. and AstraZeneca.
同行评议者
Mark Davis-Lorton, MD
Clinical Immunology Coordinator
Division of Rheumatology, Immunology and Allergy
Winthrop-University Hospital
Mineola
NY
利益声明
MDL declares that he has no competing interests.
Glenis Scadding, MD
Consultant Allergist/Rhinologist
Allergy & Rhinology Department
Royal National Throat, Nose and Ear Hospital
London
UK
利益声明
GS is a consultant/advisory board member for ALK, Britannia Pharmaceuticals, CMP Therapeutics, Grupo Uriach, GSK, Merck, Sanofi-Aventis, Schering Plough, and UCB. She has received research funds from ALK, GSK, UCB, and Schering Plough. She has given talks for ALK, GSK, Merck, Schering Plough, and UCB and has co-written articles for Schering Plough and GSK.
鉴别诊断
- 非变应性鼻炎
- 急性鼻窦炎
- 慢性鼻窦炎
更多 鉴别诊断指南
- 2020 年日本变应性鼻炎指南
- 新一代变应性鼻炎及其对哮喘影响（ARIA）的变应性鼻炎指南：基于“建议分级的评估、制定和评价”（GRADE）和现实证据
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