嗜酸细胞性胃肠炎临床诊断要点分析

目的]分析嗜酸细胞性胃肠炎(eosinophilic gastroenteritis,EG)的临床诊断要点,在临床多样性表现中把握EG的特点,减少误诊率.方法]对6例EG患者的病史、临床表现、实验室检查、内镜表现等进行分析.结果]EG患者多以腹痛、腹泻为首发症状,无特异性,可出现腹水和(或)梗阻,症状与嗜酸细胞浸润的部位和深度有关；外周血和骨髓中嗜酸细胞计数明显增高,以成熟型为主,其变化随症状的有无而增减；内镜表现多为溃疡、黏膜糜烂和水肿为主,部位以胃窦、十二指肠和回盲部明显,活检可证实大量嗜酸细胞浸润,激素治疗效果好.结论]EG临床和内镜表现无特异性,外周血、腹水、嗜酸细胞,尤其是黏膜组织中嗜酸细胞增多是诊断的关键.

Analysis on Clinical Diagnosis Points of Oxyphil Cell Gastroenteritis

Objective] To analyse the clinical diagnosis points of eosinophilic gastroenteritis（EG）,to grasp EG features in its clinical multi-changes and reduce misdiagnosis rate.Method] Make analysis on 6 cases＇ disease history,clinical demonstration,tests and endoscopic demonstrations.Result] EG firstly shows stomachache and diarrhea,without specificity,and may be with ascites or/and obstruction;the symptoms are concerned with the part and depth of oxyphil cell infiltration.PB and oxyphil cells in marrow counting markedly increase,centered on mature type;the changes are increased or decreased with the symptoms.The endoscopic demonstrations are mainly ulcer,mucosa erosion and edema,obviously in sinuses ventriculi,duodenum and ileocecus,the live biopsy can prove much oxyphil cells infiltration.It can get good effect with hormone treatment.Conclusion] EG clinical and endoscopic demonstrations have no specificity;PB and ascites oxyphil cells,esp.that in mucosa are the key of diagnosis.