27例嗜酸性粒细胞胃肠炎临床特征分析  

Clinical characteristics of 27 cases of eosinophilic gastroenteritis

作　　者：何萌 韩笑 贾继东[1] 赵新颜[1] 李鹏[1] HE Meng;HAN Xiao;JIA Ji-dong;ZHAO Xin-yan;LI Peng(Liver Research Center,Beijing Friendship Hospital,Capital Medical University&National Clinical Research Center for Digestive Diseases,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院肝病研究中心,国家消化系统疾病临床医学研究中心,北京100050

出　　处：《肝脏》2024年第7期844-847,共4页Chinese Hepatology

摘　　要：目的探讨嗜酸性粒细胞胃肠炎(EGE)的临床特征。方法收集2016年1月至2023年3月于首都医科大学附属北京友谊医院确诊的27例EGE患者临床数据。根据腹水、分型、肝功能、自发缓解及预后进行亚组分析。结果27例EGE患者发病中位年龄为35岁,男性多于女性(2.3∶1)。受累的消化道部位为胃和(或)十二指肠19例,16例为黏膜型,23例外周血嗜酸性粒细胞(EOS)计数升高。浆膜型者外周血EOS计数及腹水发生率显著高于黏膜型和肌型者(12.85×10^(9)/L比8.24×10^(9)/L比11.11×10^(9)/L,P=0.029;87.50%比6.25%比0,P<0.001);接受糖皮质激素治疗患者外周血EOS计数、EOS占比及IgE水平显著高于自发缓解患者(2.77×10^(9)/L比0.56×10^(9)/L,P=0.016;29.30%比8.05%,P=0.045;200.00 IU/mL比20.39 IU/mL,P<0.001)。外周血EOS计数联合IgE对自发缓解具有良好的预测效能,AUC=0.92,95%CI:0.82~1.00。结论EGE是一种罕见的胃肠道炎性疾病,常累及胃和十二指肠;外周血EOS计数及IgE水平较高的患者推荐激素治疗。Objective This study aims to summarize the clinical characteristics of eosinophilic gastroenteritis(EGE)to enhance awareness,diagnosis,and management of the disease.Methods We retrospectively collected clinical data from 27 EGE patients diagnosed between January 2016 and March 2023 at Beijing Friendship Hospital,Capital Medical University.Subgroup analyses were performed based on ascites,classification,liver function,spontaneous remission,and prognosis.Results The onset age of the 27 EGE patients was 35.00 years,with a higher prevalence in males(Male:Female ratio,2.3:1).The stomach and/or duodenum were most commonly affected(70.37%),with the mucosal type being the predominant classification(59.26%).A majority of patients(85.19%)showed elevated peripheral eosinophil(EOS)counts.In subgroup analyses,patients with the serosal type had significantly higher peripheral EOS counts and rates of eosinophilic ascites compared to those with mucosal and muscular types(12.85 vs 8.24 vs 11.11×10^(9)/L,P=0.029;87.50%vs 6.25%vs 0,P<0.001).Patients treated with corticosteroids showed significantly higher peripheral EOS counts,EOS%,and Immunoglobulin E(IgE)levels compared to those with spontaneous remission(2.77 vs 0.56×10^(9)/L,P=0.016;29.30%vs 8.05%,P=0.045;200.00 vs 20.39 IU/mL,P<0.001).The combination of peripheral EOS count and IgE level demonstrated good predictive power for spontaneous remission(AUC 0.92,95%CI 0.82-1.00).Conclusion EGE is a rare gastrointestinal inflammatory disease that often involves the stomach and duodenum.Corticosteroid therapy is recommended for patients with elevated peripheral EOS counts and IgE levels.

关 键 词：嗜酸性粒细胞胃肠炎 糖皮质激素 治疗 自发缓解 

分 类 号：R57[医药卫生—消化系统]