14例嗜酸性粒细胞性胃肠炎的临床特点分析

Clinical analysis of 14 cases with eosinophilic gastroenteritis

关键词:  嗜酸性粒细胞胃肠炎  诊断  糖皮质激素

Key words:  eosinophils gastroenteritis  diagnosis  glucocorticoids

摘要:

目的　分析14例嗜酸粒细胞性胃肠炎（EG）患者的临床特点，探讨有效的诊断及治疗方法。方法　收集2005年7月至2015年7月14例嗜酸粒细胞性胃肠炎患者的临床资料，对14例患者的临床表现、实验室检查、胃肠镜及病理、影像学检查以及治疗效果、预后进行分析。结果　14例患者临床表现多样，50%的患者发病有诱发因素，21%患者合并其他过敏性疾病。所有患者症状中均有腹痛，其次为腹泻（36%）。其主要特点为外周血、骨髓、腹水中嗜酸性粒细胞（EC）增多，胃肠道EC浸润。14例患者均对糖皮质激素治疗有效，治疗后随访15天至5年，有3例复发，但无恶变患者。结论　嗜酸粒细胞性胃肠炎主要为青壮男性发病。以消化道症状为首发表现。外周血、骨髓中EC增多，胃肠道EC浸润为本病主要特征，需与急腹症及其他可引起EC增多的疾病相鉴别。选择糖皮质激素治疗效果好。

Abstract:

Objective　To study the clinical characteristics of eosinophilic gastroenteritis (EG) and to investigate the most effective methods for diagnosis and treatment.Methods　Clinical data were collected from 14 patients with EG between July 2005 and July 2015 in our hospital to analyze the clinical manifestations, laboratory results, endoscopic examination, pathology, treatment and prognosis.Results　50% of the EG patients had causative factors, and 21% of the patients had other allergic diseases. All the patients had symptom of abdominal pain, followed by diarrhea (36%). The patients were characterized by increased eosinophils in peripheral blood, bone marrow, and ascites, and eosinophilic infiltrate in gastrointestinal wall. Glucocorticoid was effective on the 14 patients. 3 patients had recurrence; however no malignant transformation was observed during the follow-up of 15 days to 2 years.Conclusion　EG is common in young men with digestive symptoms as the initial manifestation, and is characterized by increased eosinophils in peripheral blood, bone marrow, and ascites, and eosinophilic infiltrate in gastrointestinal wall. Glucocorticoid is effective in the treatment of EG.