嗜酸粒细胞性胃肠炎临床特点分析

目的探讨嗜酸粒细胞性胃肠炎(eosinophilic gastroenterirtis,EG)患者的临床特点,以提高临床医师对此病的认识,减少误诊和漏诊率。方法回顾性分析确诊的20例EG患者的临床表现、实验室检查、影像学检查、胃肠镜检查、病理学结果及治疗方法和效果等。结果本研究中40.0%的患者有过敏史,25.0%伴支气管哮喘。临床症状主要表现为腹痛、腹泻、腹胀、恶心、呕吐等。85.0%患者伴外周血嗜酸粒细胞增多,100%患者胃肠道黏膜组织的病理学检查见嗜酸性粒细胞浸润。在十二指肠、食管、回盲瓣等处取材,嗜酸性粒细胞的检出率50.0%。对症治疗对于轻症患者有效,激素治疗对于重症患者有效。结论 EG是过敏反应相关性疾病,其临床表现和内镜表现均无特异性,外周血和胃肠道黏膜的病理学检查中检测到嗜酸性粒细胞的增多是明确诊断的关键。内镜下在十二指肠、食管、回盲瓣取活检组织可提高诊断率。根据患者病情轻重选择不同治疗方法。

Clinical characters of eosinophilic gastroenterirtis

Objective To investigate the clinical characters of eosinophilic gastroenterirtis （EG） and avoid misdiagnosis.Methods Twenty patients with EG in the Chinese PLA General Hospital from 2008 to 2014 were studied retrospectively.The characters of EG were analyzed through the results of clinical manifestation,laboratory inspection,imageological examination,endoscope,pathological examination and treatment.Results 40％ of the patients were associated with allergy and 25％ were associated with asthma.The main clinical manifestations were abdominal pain,abdominal distention,diarrhea and vomiting.High eosinophilia was detected in the peripheral blood of 85％ patients and in the mucosal tissue of all the patients.The eosinophilia positive rate of mucosal tissue from duodenum,esophagus and ileocecal junction is high.Symptomatic treatment was suitable for mild patients and hormonotherapy was suitable for serious patients.Conclusion EG is associated with allergy.Its clinical manifestation and endoscopic performance are not special.The key to diagnosis is high eosinophilia in the peripheral blood and mucosal tissue.Draw materials from duodenum,esophagus and ileocecal junction could improve diagnostic rate.Therapies are chosen according to patients＇ condition.