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¡¾ÕªÒª¡¿±äÓ¦ÐÔ±ÇÑ×(Allergic rhinitis, AR)ÊÇÒ»ÖÖÌØÒìÐÔºôÎüµÀ¼²²¡£¬·¢²¡ÂÊÒ»Ö±³ÊÉÏÉýÇ÷ÊÆ£¬ÑÏÖØÓ°ÏìÈËÃǵÄÉíÌ彡¿µºÍÉú»îÖÊÁ¿¡£Ä¿Ç°ÆÕ±éÈÏΪ£¬¸öÈËÒÅ´«È±Ïݼ°½Ó´¥ÖÜΧ»·¾³±äÓ¦Ô­ÊÇÁ½´óÖ÷Òª·¢²¡ÒòËØ£¬µ«Æä·¢²¡»úÖÆÈÔ²»Ê®·ÖÇå³þ¡£Òò¶ø£¬ËäȻĿǰARµÄÖÎÁÆÒ©ÎïÖÖÀà½Ï¶à£¬µ«ÉÐÎÞ¸ùÖÎÒ©Îï¡£±¾ÎļòÒª×ÛÊöAR·¢²¡»úÖƼ°·ÀÖÎÒ©ÎïµÄÑо¿Çé¿ö¡£ ¡¾¹Ø¼ü´Ê¡¿ ±äÓ¦ÐÔ±ÇÑ× ·¢²¡»úÖÆ Ò©Îï ¡¾Abstract¡¿ Allergic rhinitis has been described as an inflammatory disorder of the upper airway mucosa, the prevalence of which may be increasing. It has a significant impact on people¡¯s health and quality-of-life. It has been shown that individual inheritence defect and envirenment are the main etiological factors. However, the detailed mechanisms are still to be explained. Although each of the treatments provide short or long term relief from one or more of the symptoms of allergic rhinitis, none of them could totally control the disease. The mechanisms and treatments of AR was breifly reviewed. ¡¾Key words¡¿ allergic rhinitis mechanism medicine 1 AR¸Å¿ö ARÓֳƹýÃôÐÔ±ÇÑ×£¬¿ÉÒÔ¶¨ÒåΪÒì³£µÄ±ÇճĤÑ×Ö¢·´Ó¦¡£ÆäÁÙ´²ÌØÕ÷°üÀ¨±ÇճĤ³äѪ£¬±ÇÈû£¬±ÇÌ飬ÅçÌ磬±ÇÑ÷£¬Å¼ÓÐʧȥÐá¾õ¡£´ËÍ⣬һЩ²¡ÈËÈÌÊÜ˯Ãßʧµ÷£¬Ó°ÏìÇé¸Ð£¬Éç»á»î¶¯£¬Í·Í´£¬Ò×Å­[1]¡£ ¾¡¹ÜAR¿É·¢ÉúÓÚÈκÎÄêÁä¶Î£¬µ«ÊÇËü¸üºÃ·¢ÓÚ¶ùͯºÍÇà´ºÆÚ¡£ÔÚÃÀ¹ú£¬ARÊÇ×îΪÆÕͨµÄÌØÒìÐÔ¼²²¡£¬Ó°Ïì×Å´óÔ¼2400ÍòÈË(Ô¼8%ÃÀ¹úÈË¿Ú)¡£ÄÐÐÔ£¬Å®ÐԵò¡ÂÊÊǾùµÈµÄ¡£Á÷ÐÐÂʺÍÄêÁä¶Î¹Øϵ£º32%µÄ²¡ÈËÄêÁäÔÚ17Ëê»ò¸üС£¬43%µÄ²¡ÈËÄêÁäÔÚ1844Ë꣬17%µÄ²¡ÈËÄêÁäÔÚ45¡«64Ë꣬¼°8%ÔÚ65 Ëê»òÒÔÉÏ[2]¡£ AR¿É·ÖΪ¼¾½ÚÐԺͳ£ÄêÐÔÁ½ÖÖÇé¿ö£¬»òÕ߸ù¾Ý³Ì¶È·ÖΪÇá¶È£¬Öжȣ¬Öضȡ£ÇáÖ¢AR²»Ó°Ïì˯Ãߣ¬²»Ó°ÏìÈÕ³£»î¶¯£¬Ã»Óз³ÄÕµÄÖ¢×´¡£ÖжÈÖÁÖضȵÄAR°üÀ¨Ò»¸ö»ò¶à¸öÖ¢×´[3]¡£WHOÌáÒéARµÄ¹ú¼ÊͨÓõķÖÀàΪ¼äЪÐÔAR£¬³ÖÐøÐÔAR[4]¡£Ç°ÕßµÄÖ¢×´Ò»ÖܳÖÐøÉÙÓÚ4Ì죬һÄê³ÖÐøÉÙÓÚ4ÖÜ¡£ºóÕßµÄÖ¢×´Ò»ÖܳÖÐø¶àÓÚ4Ì죬һÄê³ÖÐø¶àÓÚ4ÖÜ¡£ 2 ARµÄ·¢²¡»úÖƱäÓ¦Ô­ÖÂÃô¹ý³Ì ³ÖÐø½Ó´¥òý³¾°££¬ó¯òë±äÓ¦Ô­£¬Ã¨¹·µÈÆäËüë·¢£¬»¨·Û¿ÅÁ£»òÆäËü±äÓ¦Ô­£¬Ò»¶Îʱ¼äºóµ¼Ö±äÓ¦Ô­µÝ³Ê£¬±äÓ¦Ô­µÝ³ÊÊÇͨ¹ý¿¹Ô­µÝ³Êϸ°ûµÝ³Ê¸øCD4+TÁÜ°Íϸ°û£¬È»ºóÊͷŲ»Í¬µÄϸ°ûÒò×Ó£¬Th2ϸ°ûÒò×Ó·Ö»¯¡£ÕâЩϸ°ûÒò×ÓÇýʹ´ÙÑ×Ö¢·´Ó¦£¬Èç²úÉúIgE, ͨ¹ý±ÇճĤ½þÈ󣬽¬Ï¸°û£¬·Ê´óϸ°û£¬ÊÈËáÁ£Ï¸°û£¬¶Ô¿¹±äÓ¦Ô­¡£Ò»µ©¶Ô±äÓ¦Ô­ÖÂÃô£¬ÔٴνӴ¥½«´¥·¢ARµÄÖ¢×´¡£ ARÓÐ2½×¶Î±äÓ¦ÐÔ·´Ó¦£º1£¬³õʼÖÂÃô½×¶Î£¬ÔÚÕâ¸ö½×¶Î£¬½Ó´¥±äÓ¦Ô­µ¼ÖÂIgEµÄÐγÉ,¼°ÌåÒº·´Ó¦µÄÓÕµ¼£¬2£¬Öظ´½Ó´¥±äÓ¦Ô­ºó²úÉúÁÙ´²¼²²¡£¬ÕâÒ»ÆÚ»¹¿ÉÒÔ¸üÉîµØ·ÖΪÔçÆÚ·´Ó¦ºÍÍíÆÚ·´Ó¦¡£ ²úÉúThÁÜ°Íϸ°û·´Ó¦µÄµÚÒ»²½ÊÇͨ¹ý¿¹Ô­µÝ³Êϸ°û(ÈçÊ÷ͻϸ°û£¬¾ÞÊÉϸ°û£¬Bϸ°û)ʶ±ð£¬ÉãÈ¡¿¹Ô­£¬¿¹Ô­µÝ³Êϸ°ûÄÜÏû»¯¿¹Ô­³ÉСëÄ£¬ÕâÖÖСëÄÓëÖ÷Òª×éÖ¯ÏàÈÝÐÔ¸´ºÏÎï·Ö×Ó(MHC)ÏàÁªÏµ£¬Ê¹Î´ÖÂÃôTϸ°ûÐË·Ü[5]¡£Ê÷ͻϸ°ûÊÇ×îÓÐЧµÄ¿¹Ô­µÝ³Êϸ°û£¬ÔÚÔÚÌåºÍÀëÌåʵÑéÖУ¬ËüÓÕµ¼£¬µ÷½Ú³õ¼¶ÃâÒßÓ¦´ð[6]¡£±ÇճĤ±»¹ã·ºµÄÊ÷ͻϸ°û¸²¸Ç£¬ËüÃÇλÓÚ°û¼äͨµÀÅÔ£¬°üΧ»ùµ×ÉÏƤϸ°û[7]¡£ δ³ÉÊìµÄÊ÷ͻϸ°ûÉãÈ¡¿¹Ô­ÓÐÈýÖÖÏÔÐÔ»úÖÆ¡£µÚÒ»£¬Í¨¹ýÊÜÌå½éµ¼µÄ(ϸ°û)ÄÚÉã×÷Ó÷½Ê½£¬µÃµ½¿¹Ô­ÎïÖÊ¡£Î´³ÉÊìµÄÊ÷״ͻϸ°û±í´ï¹ý¶àµÄÌØÒìÐÔÊÜÌ壬ÕâЩÊÜÌåÄÜʶ±ðÍ⿹ԭ£¬ÈçCÐÍÄý¼¯ËØÌÇÊÜÌå¡£µÚ¶þ£¬¿¹Ô­¿ÉÒÔ±»¾Þ°ûÒûÉãÈ¡£¬¾Þ°ûÒû²ÎÓ뼡Ï˵°°×¹Ç¼ÜÍÌʳ´óÁ¿·ÖÃÚÒººÍÈÜÖÊ¡£µÚÈý£¬Ê÷ͻϸ°ûÄÜÍÌÊÉ¿ÅÁ£ÐÍ¿¹Ô­£¬ÈçÈ齺΢Çò£¬ÍêÕûϸ¾ú£¬µòÍöϸ°û[8]¡£ ͨ¹ýÒÔÉÏ»úÖÆÉãÈ¡µÄ¿¹Ô­»ý¾ÛÔÚ°ûÍ̸ôÊÒ£¬ÔÚÕâÀ¿¹Ô­×°ÔØÔÚкϳɵģ¬ÖØÐÂÀûÓõÄMHC¢òÐÍ·Ö×Ó¡£È»¶ø£¬¿¹Ô­Ò²¿ÉÄܱ»ÔËÊäµ½°ûÒº£¬ÕâÑù£¬ËüÃÇÄܽøÈë¢ñÐÍ¿¹Ô­µÝ³Ê·¾¶[9]¡£ÔÚ°ûÍ̸ôÊÒÀ¿¹Ô­±»µ°°×Ë®½âø·Ö½âΪÃâÒßÐÔ¶ÌëÄ¡£ËáÐÔϸ°ûǻ϶ÖÐÓÐкϳɵÄMHC¢òÐÍ·Ö×Ó£¬Õâ¸öÇøÓòÓÖ³ÆΪM¢òC¸ôÊÒ£¬ÔÚÕ⣬¿¹Ô­×°ÔØÔÚMHC¢òÐÍ·Ö×ÓÉÏ[10]¡£ ͨ¹ý·ÖÃÚëÃøÀàµÄ×÷Ó㬿¹Ô­±»Î´³ÉÊìµÄÊýͻϸ°û×÷ÓòúÉúµ°°×Ë®½âÒ²·¢ÉúÔÚϸ°ûÍâ¡£Õâµ¼ÖÂëĵIJúÉú£¬ëÄÄÜ×°Ôص½¿Õϸ°û±íÃæ±í´ïMHC¢ò[11]¡£Ëæºó£¬Ê÷ͻϸ°ûÒÆÍùճĤϲ㣬µÝ³ÊÒÑ´¦ÀíµÄ¿¹Ô­¸øδ·Ö»¯µÄThÁÜ°Íϸ°û¡£¿¹Ô­-ÌØÊâTϸ°û½áºÏÊ÷ͻϸ°ûMHC¢òëĸ´ºÏÎÁ¬Í¬CD4Ï໥×÷Ó㬼°ÆäËûµÄϸ°û-ϸ°ûÐźŴ«µ¼£¬´¥·¢Tϸ°û·Ö»¯ÎªTH2ϸ°û£¬¼¤»îBϸ°û²úÉú¿¹Ô­ÌØÊâIgE[1]¡£ IgEÊÇARÖ÷Òª´¥·¢Æ÷¡£IgEÓëFc¦ÅR1ºÍµÍÇ׺ÍÁ¦ÊÜÌåFc¦ÅR2(CD23)Ï໥×÷Óá£Bϸ°û·Ö»¯ÎªIgE-·ÖÃÚÐͽ¬Ï¸°ûÐèÒªÖÁÉÙÁ½ÖÖ´æÔÚÓÚIL- 4(»òIL-13)ºÍCD40LÖв»Í¬µÄÐźż°CD40£¬CD40ÊÇÒ»ÖÖ´æÔÚÓÚBϸ°ûµÄ¸¨´Ì¼¤·Ö×Ó£¬´¥·¢Í¬ÐÍת»»ÎªIgE¡£IgE½áºÏFc¦ÅRËľÛÌ帴ºÏÎïµÄ¦ÁÁ´£¬Fc¦ÅRËľÛÌ帴ºÏÎï´æÔÚÓÚ·Ê´óϸ°û£¬ÊȼîÁ£Ï¸°û£¬µ¥ºËϸ°û£¬Ê÷ͻϸ°û¡£·Ö×Ó¼äÏ໥×÷ÓÃÓë¸ßÇ׺ÍÁ¦½áºÏÓÐÃÜÇйØϵ¡£ÕâÖÖ·Ö×Ó¼äÏ໥×÷ÓÃÊǺܸ´Ôӵģ¬Éæ¼°µ½IgEµÄC¦Å3ÁìÓòµÄһЩ²¿Î»[12]¡£ IgE´¦ÓÚ×ÔÓÉÐÎ̬ʱ£¬ËüµÄ°ëË¥ÆÚÖ»Óм¸Ìì¡£µ«µ±ÓëFc¦ÅRs½áºÏʱ£¬Ëü±»±£»¤£¬±ÜÃâ½µ½â£¬ÄÜÔÚÑ×֢ϸ°û±íÃæ´æ»îÊýÔ¡£Ñ­»·½áºÏ¿¹Ô­-ÌØÒìÐÔIgE£¬Í¨¹ý FcÇøÓò£¬Á¬½Óµ½Fc¦ÅRIÊÜÌ壬Fc¦ÅRIÊÜÌå´æÔÚÓÚ±ÇճĤ·Ê´óϸ°û»òÊȼîÐÔÁ£Ï¸°û±íÃ棬½å´Ëʹ¿¹Ô­ÌØÒìÐÔFabÇøÓò±©Â¶ÔÚ¾Ö²¿»·¾³£¬×¼±¸ºóÐø½Ó´¥±äÓ¦Ô­¶ø¼¤»î[13]¡£ ³õʼ½Ó´¥¿¹Ô­£¬¼°Æô¶¯Ñ×֢ϸ°û¶Ô¿¹Ô­Ó¦´ðµÄ¹ý³Ì£¬½ÐÖÂÃô×÷Óá£ÔٴνӴ¥Õ³Ä¤±íÃæÏàͬµÄ¿¹Ô­½«µ¼Ö½áºÏ»ò½»ÁªIgE·Ö×Ó£¬¼Ì¶øµ¼ÖÂϸ°ûÍÑ¿ÅÁ££¬ÊÍ·ÅÑ×Ö¢½éÖÊ£¬Õâ¸ö¹ý³Ì½«µ¼Ö¼±ÐÔ¼°ÂýÐÔÆÚ·´Ó¦¡£ 3 ARµÄ·ÀÖÎÒ©Îï ¾¡¹ÜÓÃÓÚÖÎÁÆARµÄÒ©ÎïºÜ¶à£¬µ«¼øÓÚÆä·¢²¡»úÖƵĸ´ÔÓÐÔ£¬Ä¿Ç°ÉÐÎÞÖÎÓúÒ©Îï¡£×ÜÌå¶øÑÔ£¬ARµÄÖÎÁÆÒ©Îï´ó¶¼ÔÚÓÚ»º½âÖ¢×´¡£ARµÄÖÎÁÆÒ©ÎïÖ÷Òª°üÀ¨×é°·H1 ÊÜÌåÞ׿¹¼ÁÀࡢƤÖÊÀà¹Ì´¼¼¤ËØÀàºÍÆäËûÀà¡£ÕâЩҩÎï¼È¿ÉÒÔµ¥Ò»ÖÎÁÆ£¬Ò²ÄÜÁªºÏÓÃÒ©ÖÎÁÆ£¬È¡¾öÓÚ»¼ÕߵĵÄÖ÷ÒªÖ¢×´ºÍ¶ÔÖÎÁƵÄÄÍÊÜÐÔ¡£ÏÂÃæ¾ÍÕâЩҩÎïµÄÊÊÓ¦Ö¢¼°¸±×÷ÓýøÐÐÌÖÂÛ¡£
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