儿童巨大肥厚性胃炎1例报告并文献分析  

PEDIATRIC MéNéTRIER’S DISEASE: A CASE REPORT AND LITERATURE REVIEW

作　　者：宋亮[1] 潘华[1] 王高燕[1] 徐雷[1] 郝风云[1] 宋爱琴[1] SONG Liang;PAN Hua;WANG Gaoyan;XU Lei;HAO Fengyun;SONG Aiqin(Children's Medical Center,The Affiliated Hospital of Qingdao University,Qingdao 266555,China)

机构地区：[1]青岛大学附属医院儿童医学中心,山东青岛266555

出　　处：《青岛大学学报（医学版）》2021年第4期617-620,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2016WS0275)。

摘　　要：目的探讨儿童巨大肥厚性胃炎(Menetrier病,MD)的临床特点,提高对该病的认识。方法回顾性分析我院确诊的1例MD病儿的临床资料,检索1990年1月—2020年1月中国知网、万方数据库和PubMed数据库中资料完整的相关文献报道,分析总结儿童MD的临床特点。结果该例确诊MD病儿突出表现为顽固性低蛋白血症和水肿,胃镜检查示胃黏膜皱襞肥厚增大,胃黏膜病理检查示腺上皮细胞显著增生。对检索到的病例进行分析,MD病儿发病年龄在22个月~15岁,临床表现为急性起病和慢性起病两种形式,急性起病临床表现为水肿及明显低蛋白血症,慢性起病以反复腹痛和呕吐为主;影像学检查均表现为胃壁厚和胃黏膜皱襞粗大,胃镜检查示胃黏膜皱襞增厚粗大、充血,胃黏膜病理检查示上皮腺体增生或扩张;均以对症治疗为主,所有病例临床症状在数周内消失,随访期间症状无反复,未行手术治疗。结论儿童MD罕见,有急性和慢性两种起病形式,以急性起病形式多见,临床表现以胃肠道症状为主,急性起病多伴有水肿及明显低蛋白血症,多合并蛋白丢失性胃病,胃镜活检和胃肠影像学检查是诊断基础,治疗以对症支持为主,预后好。Objective To investigate the clinical features of pediatric Ménétrier’s disease(MD),and to improve the awareness of this disease.Methods A retrospective analysis was performed for the clinical data of one child diagnosed with MD in our hospital,and CNKI,Wanfang Data,and PubMed were searched for related articles with complete data published from Ja-nuary 1990 to January 2020.The clinical features of pediatric MD were analyzed and summarized.Results This child had prominent manifestations of refractory hypoproteinemia and edema,with hypertrophy of the gastric mucosal folds on gastroscopy and significant proliferation of glandular epithelial cells shown by pathological examination of the gastric mucosa.Cases with complete data were retrieved for analysis,and the results showed an age of onset of 22 months to 15 years.There were two clinical types of acute onset and chronic onset;the acute-onset type showed the clinical manifestations of edema and hypoproteinemia,while the chronic-onset type showed recurrent abdominal pain and vomiting.Radiological examination showed thickened gastric wall and enlarged gastric mucosal folds,gastroscopy revealed thickening and congestion of gastric mucosal folds,and pathological examination of the gastric mucosa showed epithelial glandular hyperplasia or dilatation.All patients were given symptomatic treatment,and clinical symptoms disappeared within several weeks.No recurrence of symptoms was observed during follow-up,and no surgical treatment was performed.Conclusion Pediatric MD is rare in clinical practice and has the two types of acute onset and chronic onset,and the acute-onset type is more common.Gastrointestinal symptoms are the main clinical manifestations.Acute onset is often accompanied by edema,marked hypoproteinemia,and protein-losing gastropathy.Gastroscopic biopsy and gastrointestinal radiological examination are the basis of diagnosis,and symptomatic and supportive treatment is the main method for treatment.This disease often has good prognosis.

关 键 词：胃炎 肥厚性 儿童 病例报告 

分 类 号：R725.73[医药卫生—儿科]