儿童嗜酸粒细胞性胃肠炎36例临床特征及治疗分析  

Analysis of Clinical Characteristics and Treatment of 36 Children With Eosinophilic Gastroenterirtis

作　　者：王艳丽[1] 程艳波[2] 杜远举 

机构地区：[1]河南省郑州市第一人民医院消化儿科,450003 [2]河南省人民医院儿科 [3]河南出入境检验检疫局

出　　处：《中国全科医学》2016年第15期1803-1808,共6页Chinese General Practice

摘　　要：目的：分析儿童嗜酸粒细胞性胃肠炎（EoG）的临床特征及治疗效果。方法选取2006年9月—2015年3月郑州市第一人民医院消化儿科行胃肠镜检查确诊为 EoG 的患儿36例，记录患儿的临床表现、实验室检查结果、血清学指标、便常规、大便虫卵检测、腹部影像学检查（腹部 B 超、腹部 CT 检查）、胃肠镜检查（活检嗜酸粒细胞计数）、幽门螺杆菌（HP）测定结果、镜下（包括胃肠镜、显微镜）表现及药物治疗情况。结果患儿临床症状主要以腹痛为主（75.0％），合并症以湿疹为主（63.9％），并发症以贫血为主（52.8％）。患儿均做血常规检查，外周血嗜酸粒细胞计数升高者28例（77.8％），其中轻度升高者11例，中度升高者7例，重度升高者10例；血清 IgE 升高者30例（83.3％）；过敏原 IgE 升高者34例（占94.4％）；便常规隐血阳性者4例（11.1％），大便均未检测到寄生虫卵。36例患儿均行腹部影像学检查。腹部 B 超检查结果：胃及小肠肠壁增厚24例（66.7％），腹腔积液合并胸腔积液1例（2.8％），11例（30.5％）未检测出异常。腹部 CT 检查结果：胃及肠壁增厚27例（75.0％），其中回肠末端及盲肠肠壁增厚7例，并可见腹腔淋巴结增大。36例患儿均行胃肠镜检查，并多点活检进行嗜酸粒细胞计数，其中以胃及十二指肠活检嗜酸粒细胞计数升高者多见（58.3％），食管活检嗜酸粒细胞计数升高者较少（5.6％）。患儿 HP 检测阳性者7例（19.4％），均给予抗幽门螺杆菌治疗。36例患儿均行胃肠镜检查，胃镜下可见胃肠黏膜红斑、黏膜颗粒样改变、糜烂、出血、溃疡形成等非特异性改变，以黏膜颗粒样改变居多，为17例（47.2％），其中7例伴有溃疡形成、1例食管黏膜颗粒样改变伴有反流性食管炎；肠镜检查发现患儿结肠及回盲部黏膜颗粒增生、糜烂，活检部位1~7�Objective To investigate the clinical characteristics and treatment responses of children with eosinophilic gastroenterirtis（EoG）. Methods 36 children who were diagnosed with EoG by endoscopy in Department of Digestive Pediatric in the First People＇s Hospital of Zhengzhou City from September 2006 to March 2015,were retrospectively analyzed. The clinical manifestation,laboratory test results,serological indicators,stool test,stool parasite eggs detection,abdominal imaging studies （ abdomen B ultrasonography and abdominal CT scan）,gastrointestinal endoscopic findings（ eosinophil count for biopsy specimen）,detection of helicobacter pylori（HP）,the microscopic performance（gastrointestinal endoscopic and microscope） and medication were recorded. Results The main clinical manifestation was abdominal pain（75. 0% ）,the main comorbidity was eczema（63. 9% ）,the main complication was anemia（52. 8% ）. All cases received blood routine examination,increased＆amp;nbsp;peripheral blood eosinophil count was found among 28 cases（77. 8% ）,among these 28 cases,eosinophil count of 11 cases increased slightly,eosinophil count of 7 cases increased moderately,eosinophil count of 10 cases increased severely. Increased serum IgE level was found among 30 cases（83. 3% ）,increased allergen IgE level was foud among 34 cases（94. 4% ）,fecal occult blood test result was positive among 4 cases（11. 1% ）,parasitic ovum was not found among all cases. All cases received abdominal imageological examination. According to abdomen B ultrasonography results,24 cases（66. 7% ）had thickening of gastric wall and intestines wall,1 case（2. 8% ）had seroperitoneum complicated with pleural effusion,no positive finding was found among 11 cases（30. 5% ）. According to abdominal CT scan results,27 cases（75. 0% ）had thickening of gastric wall and intestines wall,among whom 7 cases had thickening of terminal ileum wall and cecum wall,and abdominal lymph node enlargement was found. All cases received gastr

关 键 词：嗜酸粒细胞 胃肠炎 儿童 临床特征 

分 类 号：R573.3[医药卫生—消化系统]