摘要
目的分析嗜酸细胞性胃肠炎(EG)的临床特点、诊断要点和治疗预后,并探讨其误诊原因。方法对12例EG患者的病史、临床表现、实验室检查、内镜表现和治疗随诊情况进行分析。结果黏膜型EG患者常以腹痛、恶心、呕吐、腹泻为主要表现。肌层型以肠梗阻为主要表现,可有腹痛、便秘。浆膜型以腹痛、腹胀、腹水为主要症状,可伴恶心、呕吐等。外周血和骨髓中嗜酸细胞计数明显增高(0.445±0.202,0.327±0.018),以成熟型为主,其变化随症状的有无而增减。血沉、C反应蛋白等指标正常。腹水为渗出液,可见嗜酸细胞。内镜表现多为黏膜片状糜烂、浅溃疡、散在充血斑或出血点,以十二指肠、胃窦、和回肠末端、回盲部最明显,活检可证实大量嗜酸细胞浸润。激素治疗可在1周内迅速缓解症状,并使嗜酸细胞恢复正常。结论EG临床和内镜表现无特异性,外周血嗜酸细胞、腹水嗜酸细胞,尤其是胃肠黏膜组织中嗜酸细胞增多是诊断的关键。
Objective To investigate clinical presentation, diagnosis and prognosis of eosinophilic gastroenteritis （EG） , and analyze causes of misdiagnosis. Methods Twelve patients diagnosed as EG were studied. Their history, clinical manifestations, laboratory tests and endoscopies and follow-up data were analyzed. Results The patients with mucosal type usually had abdominal pain, nausea and vomiting and sometimes with possible diarrhea. Bowel obstruction occurred generally in patients diagnosed as muscular type with or without abdominal pain. Abdominal pain, bloating and ascites occured predominantly in those with serosal type, probably accompanied by nausea, vomiting and low fever. Peripheral eosinophilic counting and bone marrow examination were markedly increased（0. 445 ± 0. 202,0. 327 ± 0. 018 ） , most of which were mature cells. The changes of cell varied with the severity of the symptoms. Levels of ESR and CRP remained in normal range. Ascites were exudative with eosinocytes. Endoscopy showed erosion and edema in antrum, duodenum and cecum. Eosinophilia infiltration in mucosa was confirmed by biopsy. Glucocorticoid therapy could relieve symptoms and eosinophilia. Symptoms probably recured by good prognosis. Conclusion Clinical and endoscopic presentations are not specific, therefore the presence of enosinphilia in peripheral blood and ascites, especially in gastrointestinal mucosa strongly indicate the diagnosis.
出处
《胃肠病学和肝病学杂志》
CAS
2008年第1期73-75,共3页
Chinese Journal of Gastroenterology and Hepatology
关键词
嗜酸细胞性胃肠炎
嗜酸细胞
临床表现
Eosinophilic gastroenteritis
Eosinocyte
Clinical manifestations
