摘要
目的探讨儿童与成人嗜酸细胞性胃肠炎(EGE)的异同,以指导EGE的临床诊治。方法回顾性选择西安市儿童医院消化科2013年2月至2018年8月收治的18例儿童EGE患者(儿童组),以及空军军医大学西京消化病医院消化内科2008年6月至2018年6月收治的24例成人EGE患者(成人组)作为研究对象。分析两组患者的一般情况、临床表现、实验室检查、影像学检查、内镜表现、病理活组织检查、治疗和预后情况。统计学方法采用卡方检验。结果儿童组中有过敏史的患者比例高于成人组[9/18比20.8%(5/24)],恶心、呕吐症状的发生率高于成人组[13/18比29.2%(7/24)],腹泻和体重下降的发生率均低于成人组[4/18比58.5%(14/24)、3/18比54.2%(13/24)],外周血嗜酸性粒细胞计数升高率低于成人组[4/18比58.3%(14/24)],差异均有统计学意义(χ^(2)=3.938、7.644、5.477、6.133、5.477,P=0.047、0.006、0.019、0.013、0.029)。两组患者内镜下表现均以黏膜充血、水肿为主(儿童组13例、成人组22例),儿童组还多见黏膜粗糙(7例)和糜烂(6例),成人组还多见黏膜糜烂(18例,75.0%)和溃疡(8例,33.3%),其中两组患者黏膜糜烂的发生率差异有统计学意义(χ^(2)=7.292,P=0.007)。儿童组和成人组患者均在回肠末端、结直肠、十二指肠取材阳性检出率较高,分别为6/6、14/15、9/18和8/10、12/15、6/8。8例接受糖皮质激素治疗的儿童组患者治疗4.5 d(2.0~27.0 d)起效,13例成人组患者治疗3.7 d(1.0~14.0 d)起效,两组糖皮质激素治疗后复发率比较(5/8比6/13)差异无统计学意义(P>0.05)。结论儿童与成人EGE患者的临床特点有所不同,可为临床医师认识和诊治EGE提供参考。
Objective To explore the similarities and differences between children and adults with eosinophilic gastroenteritis(EGE),and to guide the diagnosis and treatment of EGE.Methods From February 2013 to August 2018 at Xi′an Children′s Hospital,18 children with EGE(child group)and from June 2008 to June 2018 at Xijing Hospital of Digestive Diseases,Air Force Medical University,24 adults with EGE(adult group)were retrospectively selected as study subjects.The general data,clinical symptoms,laboratory examinations,imaging,endoscopy manifestations,pathological biopsy,treatment and prognosis of the two groups were analyzed.Chi-square test was used for statistical analysis.Results The proportion of child group with allergic history was higher than that of adult group(9/18 vs.20.8%,5/24),the incidence of nausea and vomiting was higher than that of adult group(13/18 vs.29.2%,7/24),the incidence of diarrhea and weight loss were both lower than those of adult group(4/18 vs.58.5%,14/24;3/18 vs.54.2%,13/24),and the proportion of patients with elevated peripheral blood eosinophil count was lower than that of adult group(4/18 vs.58.3%,14/24),and the differences were statistically significant(χ^(2)=3.938,7.644,5.477,6.133 and 5.477,P=0.047,0.006,0.019,0.013 and 0.029).The main endoscopic manifestations of the two groups were mucosal congestion and edema(13 cases of child group and 22 cases of adult group).Mucosal roughness(7 cases)and erosion(6 cases)were also common in child group,while mucosal erosion(18 cases,75.0%)and ulcer(8 cases,33.3%)were more common in adult group.There was a statistically significant difference in the incidence of mucosal erosion between the two groups(χ^(2)=7.292,P=0.007).The positive rates of biopsy in the terminal ileum,colorectum and duodenum of child group and adult group were both high(6/6,14/15,9/18 and 8/10,12/15,6/8,respectively).The response time of glucocorticoid treatment was 4.5 d(2.0 to 27.0 d)and 3.7 d(1.0 to 14.0 d)in child group(8 cases)and adult group(13 cases),respectively.There w
作者
王华
方莹
韩亚楠
刘佳
葛库库
刘欢宇
任晓侠
Wang Hua;Fang Ying;Han Yanan;Liu Jia;Ge Kuku;Liu Huanyu;Ren Xiaoxia(Department of Gastroenterology,Xi′an Children′s Hospital,Xi′an 710003,China;Department of Gastroenterology,Xijing Hospital of Digestive Diseases,Air Force Medical University,Xi′an 710032,China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2021年第6期397-401,共5页
Chinese Journal of Digestion
基金
陕西省重点研发计划一般项目社会发展领域(2018SF-231)。
