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  • Title: [Study on the diagnosis of idiopathic rhinitis by cold dry air provocation].
    Author: Lou H, Huang Y, Zhang L, Wang C.
    Journal: Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2020 Aug; 34(8):673-677. PubMed ID: 32842196.
    Abstract:
    Objective:This study aimed to compare the nasal response of cold dry air（CDA） provocation in patients with idiopathic rhinitis（IR） and healthy individuals, and further assess its ability in diagnosing IR. Method:CDA provocation was performed among 15 healthy volunteers and 17 IR patients from Beijing Tongren Hospital Outpatient Department. Nasal symptom scores, total nasal volume（TNV）, total nasal resistance（TNR） and minimal cross-sectional area（MCA） were checked before and after the provocation. Logistic regression analysis and Receiver Operating Characteristic（ROC） curves were used in data evaluation. Result:Subjects in the IR group showed significantly larger changes after CDA provocation in total nasal symptom score（TNSS）, total nasal resistance（TNR）, minimal cross-sectional area（MCA） and total nasal volume（TNV）, compared with healthy volunteers. We built a predictive model for IR, Y=0.394×ΔTNSS-0.061 ×ΔTNV（%）+0.014×ΔTNV（%） -2.318, whose area under curve was 0.919 based on multi-factor logistic regression and ROC curve. According to the Youden index, the cut-off criteria was set to be Y >0.49, when its sensitivity and specificity were 82.4% and 84.6%, respectively. Conclusion:Aggravated nasal symptoms and decreased nasal ventilation could be seen after CDA provocation in the IR population. The CDA provocation provides a possible method for assisting the diagnosis of IR, and we'll expand the sample size in future research to verify its clinical application value. 目的：采用干冷空气（CDA）鼻激发试验对特发性鼻炎（IR）患者进行激发前后的评估，对比2组的鼻黏膜高反应性差异，探讨CDA鼻激发试验对于IR的辅助诊断价值。 方法：本研究共纳入北京同仁医院门诊就诊的IR患者17例（IR组），以及健康无鼻炎志愿者15例（对照组）。所有受试者均接受CDA鼻激发试验，试验前后完成症状评分、鼻声反射、鼻阻力评估。应用多因素Logistic回归和ROC曲线评价该试验对IR的诊断价值。 结果：IR组经过CDA鼻激发试验后，鼻部症状总评分（TNSS）、总鼻阻力（TNR）、鼻腔最小横截面积（MCA）和鼻腔总容积（TNV）的变化值显著高于对照组。基于多因素Logistic回归和ROC曲线，建立了预测诊断模型Y=0.394×ΔTNSS-0.061×ΔTNV（%）+0.014×ΔTNV（%）-2.318，其曲线下面积为0.919。当Y >0.49时，敏感度和特异度分别为82.4%和84.6%。 结论：IR患者经CDA激发后，鼻部症状显著加重，通气功能明显受限。CDA激发试验为辅助诊断IR提供了可能的方法，并将在未来研究中扩大样本量验证其临床应用价值。.
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