嗜酸细胞性胃肠炎36例临床分析  

Eosinophilic gastroenteritis——a clinical study of 36 patients

作　　者：蔡召强[1] 王爱英[1] 吕愈敏[1] 

机构地区：[1]北京大学第三临床医学院消化内科,北京100191

出　　处：《中国内镜杂志》2010年第2期135-139,共5页China Journal of Endoscopy

摘　　要：目的探讨嗜酸细胞性胃肠炎的临床特征及诊断方法。方法收集该院1995～2008年收治的嗜酸细胞性胃肠炎患者36例,对其一般情况、临床症状、实验室检查、消化道造影、内镜及病理表现和治疗随访等情况进行系统性回顾分析、总结。结果①嗜酸细胞性胃肠炎多呈急性或亚急性病程,多有过敏性疾病病史或饮食的诱发因素。②症状以腹痛、腹泻、恶心呕吐为主,无肠外症状。③多数患者外周血嗜酸细胞计数升高。④内镜下主要为炎性改变,活检部位以小肠特别是十二指肠检出率较高,病理示胃肠道组织以大量嗜酸细胞为主的炎性细胞浸润,其中统计小肠嗜酸细胞≥38/HP。⑤治疗首选皮质激素,抗过敏、饮食调整有效。结论临床怀疑嗜酸细胞性胃肠炎时应在内镜或造影检查时行多部位活检,即使内镜和造影观察正常,也应进行黏膜活检,十二指肠是活检的关键部位,空肠活检亦能提高其诊断率。【Objective】To discuss the clinical feature of eosinophilic gastroenteritis （EG）,how to diagnosis,the treatment and prognosis of EG.【Method】Collect the EG cases who were admitted into Peking University Third Hospital from 1995 to 2008,analyze their manifestations,lab examination,imageology,endoscopic and pathological feature,treatment and prognosis.【Results】The course of most EG is acute or subacute,over 50% EG patients have allergy disease or food inducement.The predominant symptoms are abdominal pain,diarrhea,nausea and vomiting,no parenteral symptoms.Over half EG patients have eosinophilia in the peripheral blood.Endoscopy reveal the image of inflammation,the predominant location of biopsic positive founding is the intestine,especially the duodenum,pathologic findings show predominant eosinophil infiltrated in the GI tract.The pathology reveals eosinophil counted over 38/HP in the small intestine.The first choice of treatment for EG is corticosteroid,and antianaphylaxis,dietary adjustment have effect also.【Conclusion】If EG is doubtful,we should take multi-site biopsy under endoscopy or enteroclysis,even if they are normal in gross specimen.Duodenum is the critical site,jejunum biopsy can increase the rate of diagnosis.

关 键 词：嗜酸细胞胃肠炎 临床特点 内镜 病理 诊断 

分 类 号：R573.3[医药卫生—消化系统]