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支气管哮喘是常见病。过敏性哮喘病人在吸入过敏原做支气管激发试验时,可产生两种不同形式的支气管收缩反应,即速发哮喘反应(Immediate asthmatic response,IAR)和迟发哮喘反应(Late asthmatic response,LAR)。IAR 几乎在吸入过敏原的同时立即发生气流梗阻,15～30分钟达高峰,在2小时左右逐渐恢复正常。部分病人激发后6～8小时再次出现气流梗阻,12小时左右达高峰,然后逐渐恢复,称为LAR。和IAR 相比,LAR 与临床哮喘关系更密切,更接近于哮喘的自然发病。因此,近年来引起医学界的高度重视。Lockey 和Bukantz 指出:治疗哮喘病人最突出的贡献之一是认识到过敏性哮喘病人接触抗原后所产生的二次或迟发反应。本文对LAR 的病理和免疫学机理及其对临床的指导意义加以综述。
Bronchial asthma is a common disease. Allergic asthma patients can develop two different forms of bronchoconstriction reactions, namely Immediate asthmatic response (IAR) and late asthmatic response (LAR), when inhaled allergens do bronchial provocation test. Almost immediately after inhalation of allergens IAR airflow obstruction, peak 15 to 30 minutes, gradually returned to normal in about 2 hours. Some patients inspired 6 to 8 hours after the re-emergence of airflow obstruction, about 12 hours to reach the peak, and then gradually recovered, called LAR. Compared with IAR, LAR is more closely related to clinical asthma and closer to the natural history of asthma. Therefore, in recent years, the medical community has drawn great attention. Lockey and Bukantz pointed out that one of the most prominent contributions to the treatment of asthma is to recognize the secondary or delayed reaction of allergic asthma patients to antigen. This article summarizes the pathological and immunological mechanism of LAR and its clinical implications.