摘要
目的:探讨嗜酸细胞性胃肠炎(eosinophilic gastroenteritis,EG)的临床特点、误诊原因、治疗和预后。方法:选择复旦大学附属中山医院2005-2011年收治的EG患者16例,对其临床资料进行回顾分析。结果:(1)EG患者的临床表现多样,包括腹泻(9例)、腹痛(7例)、便血(5例)、低热(2例)、不完全性肠梗阻(2例)、腹水(1例);(2)EG患者中9例有过敏体质;(3)9例患者外周血中嗜酸性粒细胞(eosinophil,EOS)计数明显增高,随症状缓解而下降;(4)患者内镜检查无明显特异性表现,可见黏膜散在充血、点片状糜烂、出血灶或浅溃疡,以胃窦、十二指肠、回肠末端、回盲部最明显,活体组织检查可见大量EOS浸润;(5)影像学检查无特异性表现,13例(81.3%)黏膜型EG的CT或消化道钡餐检查无特殊发现,2例(12.5%)肌型EG肠壁肌层受累时可见不全肠梗阻,1例(6.3%)浆膜型EG出现腹水;(6)激素为治疗EG的一线药物,可迅速缓解症状并使EOS恢复正常;(7)本病是一种自限性变应性疾病,虽可反复发作,但多数患者预后良好。结论:EG的临床及内镜表现缺乏特异性,极易误诊。深层活检胃肠黏膜组织中EOS增多是诊断关键。
Objective：To investigate the clinical features, diagnosis, treatment and prognosis of eosinophilic gastroenteritis （EG） , and to analyze the cause of misdiagnosis. Methods： A total of 16 EG patients in Zhongshan hospital from 2005 to 2011 were studied . The medical history, clinical features, laboratory examination, endoscopic findings and treatment were retrospec tively analyzed. Results： （1）The symptoms of EG patients included diarrhea （9 eases）, abdominal pain （7 cases）, hematochezia （5 cases）, fever（2 cases）, incomplete intestinal obstruction （2 cases） and ascites （1 case）~ （2）Among the 16 EG patients, 9 cases were associated with allergic constitution; （3）Peripheral blood eosinophil（EOS） count increased significantly in 9 cases, and declined when symptoms were eased; （4）Endoscopic manifestations of EG patients were not specific. In the mueosa, there were sheet erosion, shallow ulcers, congestive spots or bleeding spots, mainly in antrum, duodenum, terminal ileum, ileocecal junction . The biopsy showed a large number of EOS infiltration; （5）imaging findings were not specific. CT or gastrointestinal barium meal examination results of 13 cases （81.3%） of mucous membrane type were not specific. Two cases （12. 5%） of muscular type demonstrated incomplete intestinal obstruction when intestinal muscle layer was involved. One case （6.25 %） of membrane type demonstrated ascites （6）Hormones was first-line drugs for the treatment of EG, and it can quickly relieve symptoms and supress eosinophilia; （7）EG was a type of self-limited allergic disease. Although it might recur, the prognosis was good. Conclusions： The clinical manifestations and endoscopic findings of EG lack specificity, so it is easy to be misdiag- nosed, Combining clinical features with deep biopsies of the gastrointestinal mucosa tissue is the key of diagnosis.
出处
《中国临床医学》
2012年第6期624-627,共4页
Chinese Journal of Clinical Medicine
关键词
嗜酸细胞性
胃肠炎
嗜酸细胞
临床表现
治疗
Eosinophilic
Gastroenteritis
Eosinophil
Clinical manifestation~ Treatment
