嗜酸细胞性胃肠炎的临床分析

Clinical Analysis of the Enosinophilic Gastroenteritis

目的分析嗜酸细胞性胃肠炎(EG)的临床特点,并探讨其误诊原因。方法对6例EG患者的病史、临床表现、实验室检查、内镜表现和治疗情况进行分析。结果EG患者多以消化不良为首发症状,可伴腹泻。随着疾病的发展,可出现肠梗阻和/或腹水,症状与嗜酸细胞浸润所累及的部位和深度有关。外周血和骨髓中嗜酸细胞计数明显增高,以成熟型为主,其变化随症状的有无而增减。内镜表现多为黏膜片状糜烂和水肿,以胃窦、十二指肠和回盲部明显,活检可证实大量嗜酸细胞浸润。激素可在1周内迅速缓解症状,并使嗜酸细胞恢复正常,病情可有反复,但预后良好。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 analyze clinical characteristics of the patients with enosinophilic gastroenteritis （ EG ） and study the cause of misdiagnosis. Methods Six cases of EG were analyzed in clinical characteristics,laboratory tests, endoscopy and diagnosis. Results Symptoms of dyspepsia were the commonest and earliest manifestation of EG, some patients accompanied with diarrhea. With the progress of EG, the patients might develop bowel obstruction and/or ascites. Symptoms of EG were related with the site and depth of enosinophilic infiltration in the gastrointestinal tract. Enosinophilic counts in peripheral and bone marrow had high level, and it was related with condition of illness. Endoscopies showed erosion and edema in antrum,duodenum and cecum,accompanied with enosinophilia infiltration in mucosa. The steroid hormone therapy responsion was sensitive and all symptoms were relieved and enosinophils was recovered to normal value within one week. Though their symptom recurrence was probable, good prognosis was got. Conclusion The key point for diagnosis is enosinophilia counts in peripheral blood and ascites. The biopsy of the gastrointestinal tract mucosa is also very important and helpful.