There is an increasing appreciation for the importance of inflammation as a pathophysiologic entity that contributes to functional gastrointestinal disorders including functional dyspepsia(FD).Importantly,inflammation...There is an increasing appreciation for the importance of inflammation as a pathophysiologic entity that contributes to functional gastrointestinal disorders including functional dyspepsia(FD).Importantly,inflammation may serve as a mediator between psychologic and physiologic functions.This manuscript reviews the literature implicating two inflammatory cell types,mast cells and eosinophils,in the generation of dyspeptic symptoms and explores their potential as targets for the treatment of FD.There are a number of inciting events which may initiate an inflammatory response,and the subsequent recruitment and activation of mast cells and eosinophils.These include internal triggers such as stress and anxiety,as well as external triggers such as microbes and allergens.Previous studies suggest that there may be efficacy in utilizing medications directed at mast cells and eosinophils.Evidence exists to suggest that combining "anti-inflammatory" medications with other treatments targeting stress can improve the rate of symptom resolution in pediatric FD.展开更多
Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports ...Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports available on treatment experience for eosinophilic cholangitis. A large proportion of patients present with biliary strictures for which they have undergone surgery or endoscopic treatment and a small proportion was given systemic corticosteroid. We share our treatment experience using budesonide which has fewer systemic side effects to prednisolone and avoids invasive management.展开更多
目的分析嗜酸性粒细胞升高哮喘儿童的气道炎症及肺功能特点,探讨嗜酸性粒细胞升高对哮喘儿童气道炎症及肺功能的影响。方法本研究选取2022年1月至2023年12月于山东第一医科大学附属省立医院就诊的支气管哮喘儿童为研究对象。根据外周血...目的分析嗜酸性粒细胞升高哮喘儿童的气道炎症及肺功能特点,探讨嗜酸性粒细胞升高对哮喘儿童气道炎症及肺功能的影响。方法本研究选取2022年1月至2023年12月于山东第一医科大学附属省立医院就诊的支气管哮喘儿童为研究对象。根据外周血细胞检查中嗜酸性粒细胞(EOS)绝对值检测结果将哮喘儿童分为EOS升高组和非EOS升高组。哮喘儿童均行外周血细胞检查、血清过敏原特异性免疫球蛋白E(sIgE)检测、血清总免疫球蛋白E(tIgE)检测、呼出气一氧化氮(FeNO)检测、肺通气功能检测(PFT)[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占用力肺活量比值(FEV_(1)/FVC)、最大呼气流量(PEF)、用力呼气50%肺活量的瞬间流量(FEF_(50%))、用力呼气75%肺活量的瞬间流量(FEF_(75%))、最大呼气中期流量(MMEF)]检测。分析两组儿童的一般情况、FeNO、IgE和PFT参数。结果(1)共收集464名患儿,其中EOS升高组226名,非EOS升高组238名,EOS升高组男性比例较高。(2)EOS升高组儿童tIgE水平高于非EOS升高组儿童[264(134,514)kU/L vs 61(34,178)kU/L,P<0.001],且EOS升高组儿童tIgE水平升高人数占比明显高于非EOS升高组儿童(86.28%vs 50.84%,P<0.001)。(3)EOS升高组尘螨、链格孢、烟曲霉、花粉过敏的阳性率明显高于非EOS升高组(均P<0.001),且EOS升高组儿童真菌多重过敏人数占比和尘螨高等级过敏(3、4、5、6级)人数占比均明显高于非EOS升高组儿童(均P<0.001)。(4)EOS升高组儿童FeNO水平高于非EOS升高组儿童[24(16,43)ppb vs 16(12,25)ppb,P<0.001],且EOS升高组儿童FeNO水平升高人数占比明显高于非EOS升高组儿童(80.97%vs 57.56%,P<0.001)。(5)EOS水平分别与血清tIgE水平[r_(s)=0.396,P<0.001]和FeNO水平[r_(s)=0.278,P<0.001]呈正相关。(6)EOS升高组儿童的肺功能参数水平均低于非EOS升高组儿童{FEV_(1)[(95.9±14.8)%vs(101.6±13.7)%],FEV_(1)/FVC[92.6(87.5,99.7)%vs 98.3(90.8,103.1)%],PEF[88.1(78.6,97.6)%vs 89.2(83.0,101.9)%],FEF_(50%)[(70.3±21.5)%vs(78.6±20.9)%],FEF_(75%)[53.9(41.7,70.2)%vs 64.8(51.8,81.7)%],MMEF[(67.7±22.4)%vs(76.3±21.3)%]}(均P<0.05),且EOS升高组儿童的FEV_(1)、FEV_(1)/FVC、FEF_(50%)、FEF_(75%)、MMEF下降人数占比均高于非EOS升高组儿童(均P<0.05)。结论EOS升高的哮喘儿童tIgE及过敏原sIgE阳性率升高、真菌多重过敏及尘螨高等级过敏占比增高。EOS升高的哮喘儿童FeNO水平升高,肺功能明显下降,提示EOS升高哮喘儿童更需要加强抗炎治疗,关注肺功能变化。展开更多
目的:探讨小儿支气管哮喘急性发作期肺功能变化与外周血嗜酸性粒细胞(Eosinophils,EOS)及免疫球蛋白(Immunoglobulin,IgE)水平的关系。方法:回顾性分析2022年9月-2024年7月期间本院儿科收治的95例支气管哮喘急性发作期患儿纳入观察组。...目的:探讨小儿支气管哮喘急性发作期肺功能变化与外周血嗜酸性粒细胞(Eosinophils,EOS)及免疫球蛋白(Immunoglobulin,IgE)水平的关系。方法:回顾性分析2022年9月-2024年7月期间本院儿科收治的95例支气管哮喘急性发作期患儿纳入观察组。另选取同期于我院收治的支气管哮喘缓解期87例为对照组。检测并对比两组的肺功能[用力肺活量(Forced vital capacity,FVC)、第一秒最大呼气容积(Forced Expiratory Volume in the first second,FEV_(1))、呼气流量峰值(Peak expiratory flow,PEF)]。检测并对比两组的血清EOS、IgE水平。采用Pearson相关性分析以上肺功能指标变化与EOS及IgE水平的相关性。结果:观察组的FVC、FEV_(1)、PEF水平均显著低于对照组(P<0.05)。观察组的EOS、IgE水平均显著高于对照组(P<0.05)。Pearson相关性分析结果显示:FVC、FEV_(1)、PEF均与EOS、IgE呈负相关(P<0.05)。结论:血清EOS、IgE可用于评估支气管哮喘急性期患儿肺功能情况,其水平变化可为临床治疗提供有价值的参考依据。展开更多
文摘There is an increasing appreciation for the importance of inflammation as a pathophysiologic entity that contributes to functional gastrointestinal disorders including functional dyspepsia(FD).Importantly,inflammation may serve as a mediator between psychologic and physiologic functions.This manuscript reviews the literature implicating two inflammatory cell types,mast cells and eosinophils,in the generation of dyspeptic symptoms and explores their potential as targets for the treatment of FD.There are a number of inciting events which may initiate an inflammatory response,and the subsequent recruitment and activation of mast cells and eosinophils.These include internal triggers such as stress and anxiety,as well as external triggers such as microbes and allergens.Previous studies suggest that there may be efficacy in utilizing medications directed at mast cells and eosinophils.Evidence exists to suggest that combining "anti-inflammatory" medications with other treatments targeting stress can improve the rate of symptom resolution in pediatric FD.
文摘Eosinophilic cholangitis is a rare cause of deranged obstructive liver function tests. It has been described as a great mimicker for malignant biliary strictures and bile duct obstruction. There are only case reports available on treatment experience for eosinophilic cholangitis. A large proportion of patients present with biliary strictures for which they have undergone surgery or endoscopic treatment and a small proportion was given systemic corticosteroid. We share our treatment experience using budesonide which has fewer systemic side effects to prednisolone and avoids invasive management.
文摘目的分析嗜酸性粒细胞升高哮喘儿童的气道炎症及肺功能特点,探讨嗜酸性粒细胞升高对哮喘儿童气道炎症及肺功能的影响。方法本研究选取2022年1月至2023年12月于山东第一医科大学附属省立医院就诊的支气管哮喘儿童为研究对象。根据外周血细胞检查中嗜酸性粒细胞(EOS)绝对值检测结果将哮喘儿童分为EOS升高组和非EOS升高组。哮喘儿童均行外周血细胞检查、血清过敏原特异性免疫球蛋白E(sIgE)检测、血清总免疫球蛋白E(tIgE)检测、呼出气一氧化氮(FeNO)检测、肺通气功能检测(PFT)[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占用力肺活量比值(FEV_(1)/FVC)、最大呼气流量(PEF)、用力呼气50%肺活量的瞬间流量(FEF_(50%))、用力呼气75%肺活量的瞬间流量(FEF_(75%))、最大呼气中期流量(MMEF)]检测。分析两组儿童的一般情况、FeNO、IgE和PFT参数。结果(1)共收集464名患儿,其中EOS升高组226名,非EOS升高组238名,EOS升高组男性比例较高。(2)EOS升高组儿童tIgE水平高于非EOS升高组儿童[264(134,514)kU/L vs 61(34,178)kU/L,P<0.001],且EOS升高组儿童tIgE水平升高人数占比明显高于非EOS升高组儿童(86.28%vs 50.84%,P<0.001)。(3)EOS升高组尘螨、链格孢、烟曲霉、花粉过敏的阳性率明显高于非EOS升高组(均P<0.001),且EOS升高组儿童真菌多重过敏人数占比和尘螨高等级过敏(3、4、5、6级)人数占比均明显高于非EOS升高组儿童(均P<0.001)。(4)EOS升高组儿童FeNO水平高于非EOS升高组儿童[24(16,43)ppb vs 16(12,25)ppb,P<0.001],且EOS升高组儿童FeNO水平升高人数占比明显高于非EOS升高组儿童(80.97%vs 57.56%,P<0.001)。(5)EOS水平分别与血清tIgE水平[r_(s)=0.396,P<0.001]和FeNO水平[r_(s)=0.278,P<0.001]呈正相关。(6)EOS升高组儿童的肺功能参数水平均低于非EOS升高组儿童{FEV_(1)[(95.9±14.8)%vs(101.6±13.7)%],FEV_(1)/FVC[92.6(87.5,99.7)%vs 98.3(90.8,103.1)%],PEF[88.1(78.6,97.6)%vs 89.2(83.0,101.9)%],FEF_(50%)[(70.3±21.5)%vs(78.6±20.9)%],FEF_(75%)[53.9(41.7,70.2)%vs 64.8(51.8,81.7)%],MMEF[(67.7±22.4)%vs(76.3±21.3)%]}(均P<0.05),且EOS升高组儿童的FEV_(1)、FEV_(1)/FVC、FEF_(50%)、FEF_(75%)、MMEF下降人数占比均高于非EOS升高组儿童(均P<0.05)。结论EOS升高的哮喘儿童tIgE及过敏原sIgE阳性率升高、真菌多重过敏及尘螨高等级过敏占比增高。EOS升高的哮喘儿童FeNO水平升高,肺功能明显下降,提示EOS升高哮喘儿童更需要加强抗炎治疗,关注肺功能变化。
文摘目的:探讨小儿支气管哮喘急性发作期肺功能变化与外周血嗜酸性粒细胞(Eosinophils,EOS)及免疫球蛋白(Immunoglobulin,IgE)水平的关系。方法:回顾性分析2022年9月-2024年7月期间本院儿科收治的95例支气管哮喘急性发作期患儿纳入观察组。另选取同期于我院收治的支气管哮喘缓解期87例为对照组。检测并对比两组的肺功能[用力肺活量(Forced vital capacity,FVC)、第一秒最大呼气容积(Forced Expiratory Volume in the first second,FEV_(1))、呼气流量峰值(Peak expiratory flow,PEF)]。检测并对比两组的血清EOS、IgE水平。采用Pearson相关性分析以上肺功能指标变化与EOS及IgE水平的相关性。结果:观察组的FVC、FEV_(1)、PEF水平均显著低于对照组(P<0.05)。观察组的EOS、IgE水平均显著高于对照组(P<0.05)。Pearson相关性分析结果显示:FVC、FEV_(1)、PEF均与EOS、IgE呈负相关(P<0.05)。结论:血清EOS、IgE可用于评估支气管哮喘急性期患儿肺功能情况,其水平变化可为临床治疗提供有价值的参考依据。
