20例嗜酸性粒细胞性胃肠炎临床及内镜特点分析  

Clinical and endoscopic features in 20 cases of eosinophilic gastroenteritis

作　　者：黄焕军[1] 刘瑶[1] 刘南植[1] 田德安[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,武汉430030

出　　处：《临床内科杂志》2008年第6期413-415,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨嗜酸性粒细胞性胃肠炎（EG）患者的临床表现及内镜检查对该病的诊治价值。方法对20例EG患者的临床特点、试验室检查、内镜表现和治疗随诊情况进行分析。结果20例患者中黏膜型12例、浆膜型2例、混合型6例;EG临床表现以腹痛为主,可伴有腹胀、腹泻、腹水、恶心、呕吐;外周血和骨髓中嗜酸性粒细胞计数明显增多（13.5%-50.6%和7.8%-38.5%）,腹水中可见大量嗜酸性粒细胞;内镜表现为黏膜充血水肿、糜烂,病理检查可见大量嗜酸性粒细胞浸润;糖皮质激素治疗1-2周内可迅速缓解症状,减量维持,然后逐渐减量至停药;病情可反复,但预后良好。结论EG患者临床和内镜表现无特异性,外周血和腹水中嗜酸性粒细胞计数明显增多,胃肠黏膜组织中嗜酸性粒细胞浸润是诊断的关键,糖皮质激素治疗效果良好。Objective To evaluate the value of clinical manifestations and endoscopy in the diagnosis of eosinophilic gastroenteritis.Methods 20 cases with eosinophilic gastroenteritis were analyzed retrospectively in clinical characteristics,labaoratory tests,endoscopic manifestations,treatment and prognosis.Results In all the patients with eosinophilic gastroenteritis,12 of them were predominant mucosal type,2 wrere serosal type and 6 were muscular type.The main manifestations of patients with eosinophilic gastroenteritis were abdominal pain,which coupled with bloating,diarrhea,ascites,nausea and vomiting; the eosinophilic counts in peripheral blood and bone marrow of all the patients with EG were high.The proportions of eosinophilic cells in peripheral blood and bone marrow were 13.5%-50.6% and 7.8%-38.5%,respectively; the ascites was associated with eosinophils in the peritoneal fluid; endoscopy showed hyperaemia,edema and erosion in gastroenterologic mucosa.The mucosa was infiltrated with eosinophils.The steroid hormone therapeutic response was good; all sympotoms were relieved within one to two weeks; the dose of the therapy was tapered gradually and stopped.Symptoms could recur but the prognosis is good.Conclusion The clinical and endoscopic manifestations of the patients with eosinophilic gastroenteritis had no specific characteristics.The enosinophilic counts in peripheral blood and ascites were high.The pathology of the gastrointestinal mucosa is the key point for diagnosis of EG,and steroid acts quickly and leads to perfect result.

关 键 词：嗜酸性粒细胞性胃肠炎 内镜/诊断 治疗 

分 类 号：R57[医药卫生—消化系统]