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近年来经常应用抗原吸入诱发哮喘试验来研究哮喘的病因性变应原。通常有三种反应类型:速发(立即)型哮喘反应(IAR);迟发型哮喘反应(LAR);双相型哮喘反应(DAR)。1952年Herxheimer首先指出LAR的重要性,此后对迟发型哮喘的临床意义受到重视,各个侧面的报道增多。著者综述了迟发型哮喘的晚近进展。根据Pepys等的定义,所谓迟发型哮喘是在吸入抗原后4～6小时开始,8～12小时到达高峰,24小时后消失,这样的LAR实际上是复发性夜间哮喘性反应(RNAR)。但迟发型哮喘还有一种持续型,即症状发生迟,持续时期长,重者症状渐渐增剧可持续数日。LAR可以单独存在,但在多数情况下,先有IAR或呈DAR者也不少。引起LAR的变应原曾报告过各种各样的物质,一般变应原如室尘、真菌、花粉、鸟类的蛋白质成分等;职业性的变应原如枯草杆菌、各种木材、红杉、棉制品和各种化合物等。在病情方面,LAR常伴有发热和白细胞增多。对药物的效:色甘应酸二钠对IAR和LAR均能抑制,而异丙肾上腺素对IAR疗效显著,但对LAR则无效;肾上腺皮质激素对IAR无效,但对LAR有显效。
In recent years, frequent use of antigen-induced asthma test to study the etiology of asthma allergens. There are usually three types of reactions: immediate-onset (IAR) asthma; late-onset asthma (LAR); bipolar asthma (DAR). Herxheimer first pointed out the importance of LAR in 1952, and then the clinical significance of late-onset asthma has been paid attention to, and the reports of all sides have been increased. The authors review the recent advances in late-onset asthma. According to the definition of Pepys et al., The so-called delayed type asthma starts 4-6 hours after antigen inhalation, peaks from 8-12 hours and disappears after 24 hours. Such LAR is actually a recurrent nociceptive reaction (RNAR). However, delayed type asthma there is a sustained type, that is, the symptoms occur late, long duration, severe symptoms gradually increased for several days. LAR can exist alone, but in most cases, IAR or DAR is not less. Allergens that cause LAR have been reported a variety of substances, the general allergens such as room dust, fungi, pollen, the protein composition of birds, etc .; occupational allergens such as Bacillus subtilis, all kinds of wood, red Fir, cotton products and various compounds. In the disease, LAR often accompanied by fever and leukocytosis. Effect on the drug: Disodium chrooghonate inhibits both IAR and LAR, whereas isoproterenol has a significant effect on IAR but not on LAR; adrenocorticotropic hormone is not effective on IAR, but not on LAR.