嗜酸性膀胱炎3例报告并文献复习

Eosinophilic cystitis:Report of 3 cases and review of the literature

目的：探讨嗜酸性膀胱炎的临床诊断和诊治方法。方法：回顾性分析3例嗜酸性膀胱炎患者临床资料，并结合相关文献综合分析讨论本病病因学、诊断和治疗。结果：3例患者起病均有膀胱下尿路刺激症状、镜下或肉眼血尿，B超见膀胱壁增厚和（或）膀胱新生物。经膀胱镜检查并活检确诊为嗜酸性膀胱炎。其中1例患者经电切后口服抗感染、抗过敏药物后好转，1例考虑为寄生虫感染患者加用抗寄生虫药物后好转；1例病灶电切后反复发作，经仔细追问病史，患者有虾蟹过敏史，经抗过敏及禁食虾蟹后未再发作。随访18～128个月，平均随访72个月，预后良好。结论：嗜酸性膀胱炎确诊需要膀胱镜检查及组织活检。治疗上以消除病因，切除病变组织和抗炎、抗过敏等治疗方法。本病容易复发，需要长期强制性随访。

Objective：To investigate the clinical diagnosis and treatment of eosinophilic cystitis. Methods： Three cases of eosinophilic cystitis was reported, the etiology, diagnosis and treatment were analyzed, the related literature was reviewed. Result：All the 3 patients had lower urinary tract symptome, 2 had micrscopic hematuria, 1 had gross hematuria. Bladder wall thickenning phenomenon was found in all three patients, and bladder neoplasms were found in two by ultrasonography. Diagnosis of eosinophilic cystitis were confirmed by cystoscopy and biopsy. One of them who had no certain cause and had neoplasm was treated by transurethral resection and then took antiinflamation and anti-allergic drugs. One who had eggs of distoma hepaticum took additional pesticide. The last one who had allergen of shrimp and crab was told not to eat such food, and underwent transurethral resection of neoplasm in the bladder. Conclusions： Eosinophilic cystitis is a very rare and tumor-like inflammatory disease. Ultrasonography is a very good and efficient for diagnosis. Cystoscopy and biopsy are the gold standard for the diagnosis. The principle of treatment are eliminating causative agent, removing lesions, anti-allergic therapy. Long term follow up is mandatory as the lesion tends to recur in spite of the above therapy.