Urticaria
Urticaria
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DOI：
10.1111/j.1610-0387.2008.06661.x
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发表时间：
2008-04-01
影响因子：
3.6
通讯作者：
Wedi, Bettina
中科院分区：
文献类型：
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作者：
Wedi, Bettina
荨麻疹和血管性水肿是常见的，如果是慢性的，通常持续多年，对生活质量和职业能力有显著影响。为了更好地了解疾病的病因和发病机制，并比较临床试验，有一个明确的需要跨专业和国际协议的命名和诊断分类荨麻疹和血管性水肿。在确定荨麻疹亚型后，应寻找潜在的触发因素，包括持续性细菌感染（幽门螺杆菌、链球菌、葡萄球菌、耶尔森氏菌、寄生虫）假变态反应（乙酰水杨酸，很少有食品添加剂）和/或自身反应机制（自体血清试验）。确定的触发因素应避免或根除，因为这是最成功的治疗方法。大多数荨麻疹亚型的治疗是困难的，除了HI抗组胺药既不标准化，也没有证据为基础。低分泌HI抗组胺药代表了治疗的主流，因为它们比旧药物具有更好的治疗指数和药效学特性。在严重的情况下，必须增加其剂量，这是标签外使用。替代治疗的证据基础完全不足，应仔细考虑每种标签外使用药物的风险-获益特征。
Urticaria and angioedema are common and, if chronic, often persist for years with significant impact on quality of life and occupational ability. To achieve a better understanding of disease etiology and pathogenesis and to compare clinical trials, there is a clear need for cross-specialty and international agreement of the nomenclature and diagnostic classification of urticaria and angioedema. At least in part this has been achieved by two recently published European guidelines.After the urticaria subtype is defined, potential triggers should be sought including persistent bacterial infections (Helicobacter pylori, streptococci, staphylococci,Yersinia, parasites) pseucloallergic reactions (acetylsalicylic acid, rarely food additives) and/or autoreactive mechanisms (autologous serum test). Identified trigger factors should be avoided or eradicated, as this is the most successful therapeutic approach.Treatment of most urticaria subtypes is difficult and besides HI antihistamines neither standardized nor evidence-based. Low-seclating HI antihistamines represent the mainstay of treatment, as they have a better therapeutic index and pharmacodynamic properties than older agents. In severe cases their dose has to be increased which is off-label use. The evidence base for treatment alternatives is totally insufficient and the risk-benefit profile of each off-label used drug should be carefully considered.