以肺栓塞为首发表现的高嗜酸粒细胞综合征一例并文献复习  

Hypereosinophilic syndrome initially presenting pulmonary embolism： a case report and review of literature

作　　者：李莉[1] 吴琦[1] 史丽霞[1] 胡金苗[1] 孙昕[1] 杜钟珍[1] 

机构地区：[1]天津医科大学天津市海河医院呼吸科,300350

出　　处：《中华结核和呼吸杂志》2013年第9期675-678,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的分析高嗜酸粒细胞综合征伴多发血栓形成的临床特征，提高临床对嗜酸粒细胞增多导致血栓性疾病的认识。方法以“嗜酸粒细胞增高、血小板减少、深静脉血栓形成”为中文关键词，“hypereosinophilic, thrombocytopenia, deep vein thrombosis”为英文关键词检索2002年1月-2012年1月万方数据库和Pebmed数据库的相关文献，共获得9篇，其中中文5篇，英文4篇，排除未明确诊断的2篇文献，共纳入7篇，报道了8例患者，其中男5例，女3例，年龄24—75岁，结合文献报道的病例特点及本病例特征进行文献复习。结果患者男，27岁，以胸痛气短伴痰中带血起病，经胸部强化CT确诊肺栓塞，同时有下肢深静脉血栓形成，实验室检查提示血嗜酸粒细胞增高和血小板下降。结合文献嗜酸粒细胞增高可损伤血管内皮细胞，导致多发动静脉血栓形成，抗凝同时应用糖皮质激素治疗有效。结论高嗜酸粒细胞综合征是嗜酸粒细胞增多症的一种，临床以多器官受累为表现，伴多发血栓形成，抗凝治疗同时应用皮质激素可降低嗜酸粒细胞计数，减少其血管内皮损伤对血栓形成的影响。Objective To analyze clinical features of hypereosinophilic syndrome with multiple thrombosis and improve the understanding of eosinophilia resulting in thrombotic diseases. Methods ＂ Eosinophils increased, thrombocytopenia, deep vein thrombosis ＂, as the Chinese keywords, ＂hypereosinophilic,thrombocytopenia, deep vein thrombosis＂ as the English key words and to retrieve the literature from Wanfang database and Pebmed database in January 2002--January 2012, a total of 17 articles, 5 Chinese articles, 4 in English , exclude those 2 articles which do not clearly diagnosis, a total of 7 articles were included, reports 8 cases, including 5 male, 3 female, age ranged from 24 to 75, combine the characteristics of the cases which reported in these literatures and our case ,to make a literature review. Results A male, 27 years old, complains shortness of breath, chest pain and blood in the sputum, pulmonary embolism diagnosed by chest enhanced CT, while deep vein thrombosis was diagnosed, laboratory examinations showed that blood eosinophils and thromboeytopenia. According to the literature that eosinophils can damage the vascular endothelial cells, leading to multiple arterial and venous thrombosis, antieoagulation while glueocorticoid treatment is effective. Conclusions As one of eosinophilia, hypereosinophilic syndrome can involve multiple organs and cause multiple thrombosis. Anticoagulation and corticosteroids can reduce eosinophil count and decrease its toxins which can injure vascular endothelial.

关 键 词：嗜酸粒细胞增多 血小板减少 肺栓塞 下肢深静脉血栓形成 

分 类 号：R563.5[医药卫生—呼吸系统]