过敏性鼻炎(英文版)ppt课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Allergic Rhinitis,Allergic Rhinitis,CONCEPT,Allergic Rhinitis is an IgE-mediated,type 1 hypersensitivity reaction in the mucous membranes of the nasal airway.,CONCEPTAllergic Rhinitis is an,ARIA,Allergic rhinitis is defined clinically by nasal hypersensitivity symptoms induced by an immunologically mediated(most often IgE-dependent)inflammation after the exposure of the nasal mucous membranes to an offending allergen.,Symptoms of rhinitis include rhinorrhea,nasal obstruction or blockage,nasal itching,sneezing,and postnasal drip that are reversible spontaneously or under treatment.,Allergic conjunctivitis often accompanies allergic rhinitis.,We classified allergic rhinitis as intermittent or persistent according to the duration of symptoms,and as mild or moderate-severe according to the severity,ARIAAllergic rhinitis is defin,过敏性鼻炎(英文版)ppt课件,过敏性鼻炎(英文版)ppt课件,Background,T,otal cost$5.3 billion per year.(in America),Morbidity 10%-40%(in China),Classification,Perennial allergic rhinitis,Seasonal allergic rhinitis(pollinosis),BackgroundTotal cost$5.3 bill,Pathophysiology,Allergic reaction is an exaggerated or inappropriate immune reaction and causes damage to the host,Type I immediate hypersensitivity reaction,mediated by IgE antibodies,which trigger the mast cells and basophils to release pharmacologically active agents.,Pathophysiology Allergic react,过敏性鼻炎(英文版)ppt课件,CLINICAL,History:,Obtaining a detailed history is important in the evaluation of allergic rhinitis.,Allergy history,environmental exposures,occupational exposures,effects on quality of life,Family history,Past medical history,CLINICALHistory:Obtaining a d,Predisposing factors,Genetic factors,Increase in exposure to allergen,air pollution and irritants(smoke,gas),Decrease in infections,(,Worm vs.Wealth-HygieneHypothesis,),Foods,Stress,Predisposing factors Genetic f,Allergen,House dust mite,Pollen:,tree,grass,weed,Mould spore:,Cladosporium,Alternaria,Aspergillus,Penicillum,Animal products:,dander,feather,saliva,urine,(cat,dog,cow,horse,sheep,etc.),Others:,cockroach,flour,foods,etc.,AllergenHouse dust mite,CLINICAL,Symptoms and Signs of Allergic Rhinitis,Sneezing(,paroxysmal,),Itching(nose,eyes,ears,palate),Rhinorrhea,（,watery secretions),Congestion,Hyposmia,CLINICALSymptoms and Signs of,Signs,Nasal crease(allergic salute).,Signs,Nasal Crease,Nasal Crease,Signs,Allergic shiners,Nasal examination:swollen(boggy),pale,blue-gray mucosa,SignsAllergic shiners,Allergic rhinitis:Classification,Seasonal,Outdoor allergens(pollens,moulds),Perennial,Indoor allergens,(dust mites,moulds,insects,animal dander),Occupational,Allergic rhinitis:Classificat,Allergic rhinitis:Classification,Intermittent,The symptoms are present,less than 4 days a week,or for,less than 4 weeks,Persistent,The symptoms are present,more than 4 days a week,or for,more than 4 weeks,Allergic rhinitis:Classificat,Allergic rhinitis:Classification,Mild,None of the following items are present,Sleep disturbance,Impairment of daily activities,leisure and/or sports,Impairment of school or work,Troublesome symptoms,Moderate-severe,One or more of the above items are present,Allergic rhinitis:Classificat,Lab Studies,Total serum IgE,Finding allergen,Common allergen:,Perennial:house dust,mite,fungus,pollen,chemical material,Seasonal:pollen(sunflower,corn,glass),Lab Studies Total serum IgE,Lab Studies,Finding allergen,a.Skin testing,:prick test,（点刺试验）,intracutaneous test,（皮内试验）,b.Nasal allergen challenge test,c.Serum special IgE determination,Lab StudiesFinding allergen,Diagnosis,history,Clinical manifestation,Allergy diagnosis,Diagnosishistory,Allergic rhinitis:Diagnosis(I),History,Symptoms,sneezing,nasal itching,rhinorrhea,nasal obstruction,hyposmia,Personal atopic disease,General ENT examination,pale,boggy,edematous mucosa,allergic stigmata:shiners,allergic salute,nasal crease,adenoidal face,Allergic rhinitis:Diagnosis,Allergic rhinitis:Diagnosis(II),Blood eosinophil count,Nasal cytology,(nasal smear),:,eosinophilia,Allergic rhinitis:Diagnosis,Allergic rhinitis:Diagnosis(III),Total serum IgE,Specific IgE,Skin test:Prick test,Intradermal test,Serum specific IgE:RAST,MAST,FAST,CAP,Allergic rhinitis:Diagnosis,Allergic rhinitis:Diagnosis(IV),Nasal provocation test,(challenge test),Other assessments,nasal airway(rhinomanometry,AR),olfaction,radiology,bacteriology,mucociliary function,Allergic rhinitis:Diagnosis,Differential Diagnosis,Vasomotor rhinitis,血管运动性鼻炎,Differential DiagnosisVasomoto,Complication,Allergic sinusitis,过敏性鼻窦炎,Asthma,哮喘,Secretory otitis media,分泌性中耳炎,ComplicationAllergic sinusiti,Treatment,Medical Care,(1)Avoidance,Environmental controls and,allergen avoidance,(2)Pharmacotherapy,(3)Immunotherapy,TreatmentMedical Care,Treatment,(2)Pharmacotherapy,a.Steroid:topicalnasal steroid sprays,general,b.Antihistamines:H,1,-receptor antagonist,First-generation:toldrin (drowsiness,),2,nd,/3,rd,-generation:clarity(dont