摘要
目的探讨以大量腹水为首发症状的儿童嗜酸细胞性胃肠炎（EG）的临床表现及胃镜特征，为临床早期诊断和治疗该病积累经验。方法对南京医科大学附属南京儿童医院2009年5月至2012年12月收治的6例EG患儿的临床特点、实验室检查、胃镜表现和治疗情况进行分析。结果6例患儿均为EG浆膜病变型，主要临床表现为腹胀、腹水；外周血嗜酸性粒细胞（EOS）计数明显增多（5．1×10^9／L～20．6×10^9／L），患儿腹水中均见大量EOS；内镜下表现为6例均有胃黏膜充血水肿，其中2例胃窦黏膜散在糜烂，1例食管下段黏膜粗糙水肿，3例十二指肠黏膜充血水肿，1例十二指肠球部结节样增生，6例黏膜病理检查均可见EOS增多；予回避可疑食物，口服糖皮质激素治疗1周后，症状缓解。结论EG浆膜型患儿常以大量腹水为首发症状，外周血和腹水中EOS计数明显增多，内镜下为非特异性表现，为黏膜充血水肿、糜烂、结节样增生等，胃肠黏膜多点活检病理可见固有层EOS浸润，饮食疗法、糖皮质激素治疗效果良好。
Objective To explore the clinical manifestations and endoscopic characteristics of eosinophilic gastroenteritis （EG） with massive ascites as the initial symptom and accumulate the experiences of EG for early diagnosis and treatment. Methods Clinical characteristics, laboratory examination, endoscopic features and treatment methods of 6 cases of pediatric patients with EG from Nanjing Children＇s Hospital Affiliated to Nanjing Medical University from May 2009 to Dec. 2012 were analyzed. Results The main clinical manifestations of 6 eases with EG serous type were abdominal distension, ascites. Peripheral blood eosinophil （ EOS ） counts was increased significantly （ 5. 1 ×10^9/L - 20. 6 ×10^9/L）. A large number of EOS were found in ascitic fluid of 6 patients. Endoscopic manifestations was gastric mucosal hyperemia and edema in the all of 6 patients, and furthermore, gastric mucosa erosion in 2 cases, esophagus mueosa rough edema in 1 ease, duodenal mueosal hyperemia and edema in 3 eases, duodenal nodular hyperplasia in 1 ease. The mueosa pathological examination of 6 cases showed eosinophilia. Symptoms in patients were relieved after avoiding suspicious food and oral corticosteroids treatment after 1 week. Conclusions EG serous type patients in children are massive aseites as the initial symptom. Ascitic fluid and peripheral blood EOS counts are increased significantly and endoscopic feature is nonspecifie, mucosal hyperemia, edema, erosions, nodular hyperplasia. EOS infiltration is observed in the gastrointestinal mueosa propria by multipoint biopsy. Therapeutic effect of diet therapy and the treatment of glucocorticoid is good.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第7期528-529,共2页
Chinese Journal of Applied Clinical Pediatrics
关键词
嗜酸细胞性胃肠炎
腹水
儿童
Eosinophilic gastroenteritis
Ascites
Child
