嗜酸粒细胞性胃肠炎16例临床分析

目的通过对嗜酸粒细胞性胃肠炎（EG）患者的临床资料进行总结分析，以提高临床医师对该病的认识，避免误诊误治。方法回顾性分析确诊的16例嗜酸粒细胞性胃肠炎患者的临床表现、实验室检查、内镜检查、病理检查、影像学检查及治疗预后等资料。结果本组资料中43．75％的患者与过敏有关。常见临床表现为腹痛（87．5％）、腹泻（43．8％）、呕吐（43．8％）、腹水（31.3％）。77．8％的患者外周血嗜酸粒细胞计数升高，腹水中可见大量嗜酸粒细胞浸润。内镜检查表现为黏膜充血、水肿、糜烂，病理见大量嗜酸粒细胞浸润。16例患者均予以激素治疗，疗效良好。结论嗜酸细胞性胃肠炎的临床表现和内镜表现无特异性，多数患者外周血、腹水和骨髓中嗜酸粒细胞计数明显增高，内镜下黏膜活检和腹水嗜酸粒细胞增多是明确诊断的关键，CT、超声内镜检查有助于确诊。糖皮质激素治疗有效。

Clinical analysis of 16 patients with eosinophilic gastroenteritis

Objective To analyze the clinical data of eosinophilic gastroenteritis for improving the recognition of this disease and avoiding misdiagnosis and mistreatment. Methods All 16 cases with eosinophilic gastroenteritis were retrospectively analyzed in clinical feature, laboratory tests, endoscopic manifestations, pathological examination, imaging examination,treatment and prognosis. Results About 43.75% of the EG patients were associated with allergy. The common clinical presentations were abdominal pain （87.5%） ,diarrhea （43.8%）, vomiting （43.8%） ,ascites （31.3%）. The rates of eosinophilia （EOS） in peripheral blood were elevated in 77.8%. The Ascites were infiltrated with eosinophilia. Endoscopic manifestations were hyperemia,edema and erosion. The mucosas were infiltrated with eosinophilia.Glucoeorticoids were used in all the patients with good effects. Conclusion EG is a rare disease with non-specific manifestations. The eosinophilic counts in peripheral blood,bone marrow and aseites are high in most of the patients. Increased eosinophil counts in the gastrointestinal mucosa and ascites are key to the diagnosis of EG. Computer tomography and endoscopic ultrasound help to confirm the diagnosis. Glucocorticoids are effective for EG.