嗜酸细胞性胃肠炎的临床特点分析

Clinical analysis of patients with eosinophilic gastroenteritis

目的分析嗜酸细胞性胃肠炎(EG)的临床特点、治疗预后及误诊情况。方法回顾性分析8例EG患者的病史、临床表现、实验室检查、内镜表现、误诊及治疗情况。结果本组EG患者黏膜型7例,浆膜型1例。黏膜型以腹痛、恶心、呕吐、腹泻为主要症状;浆膜型以腹痛、腹胀、腹水为主要表现,可伴恶心、呕吐和低热等。外周血中嗜酸细胞计数及百分比明显增高。腹水为渗出液,可见嗜酸细胞。EG的内镜检查表现没有特异性,多为黏膜片状糜烂、浅溃疡、散在充血斑或出血点,活检提示病变部位受累黏膜有大量嗜酸性粒细胞浸润。激素治疗迅速缓解症状,并使嗜酸细胞恢复正常。症状虽可反复发作,激素远期疗效也甚好。结论 EG患者临床和内镜表现复杂多样,缺乏特异性,极易误诊。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 the clinical characteristics, therapy prognosis, misdiagnosis of Eosinophilia Gastroenteritis （EG）. [ Methods ] 8 patients diagnosed as EG were studied with the data concerning the medical history, clinical manifestations, laboratory tests, endoscopic test, misdiagnosis and therapy.[Results] Among the EG patients, seven are mucosal type, and one is serosal type. The patients with mucosal type usually had abdominal pain, nausea, vomit, and diarrhea. Abdominal pain, bloating and ascites occur predominantly in those with serosal type, incidentally with nausea, vomit and low fever and so on. Increased peripheral eosinophilia count was noted in these cases, of which the percentage obviously rised. Ascites was the exuding liquid, in which Eosinophilia could be detected. Endoscopic examination revealed no other Specificities, but edema, erosion, hemorrhage and ulcer. Biopsy illustrated that there were a large amount of Eosinophilic in the lesions. Glucocorticoid therapy could relieve symptoms and eosinophilia. Symptoms probably recur by good prognosis.[ Conclusion] Clinical and endoscopic presentations are Complex and diverse, but not specific, which may leads to misdiagnosis. The presence of eosinophilia in peripheral blood and ascites, especially the increase of eosinophilia indicate the diagnosis.