嗜酸性粒细胞性胃肠炎14例临床分析

Eosinophilic Gastroenteritis:Clinical Experience with 14 Patients

目的分析嗜酸性粒细胞胃肠炎(eosinophilic gastroenteritis,EG)的临床特点、诊断要点、治疗和预后。方法对14例诊断为嗜酸粒细胞性胃肠炎患者的病史、临床表现、实验室检查、内镜检查、病理结果、治疗及随访情况进行回顾性临床分析。结果 14例EG患者中,10例病变范围涉及黏膜层,1例病变范围涉及肌层,3例病变范围涉及浆膜层。所有患者均出现不同程度的胃肠道症状,内镜下黏膜活检或手术活检均证实胃肠道组织有较多量嗜酸性粒细胞浸润。给予糖皮质激素类治疗的9例患者,1～2周后症状得到明显缓解,且嗜酸性粒细胞数逐渐下降至正常水平。14例患者均预后良好。结论嗜酸性粒细胞性胃肠炎是临床上较为少见的一种疾病,病因和发病机制尚不十分明确。内镜或手术取到活体组织中提示较多嗜酸性粒细胞浸润是确诊的关键。糖皮质激素是主要的治疗药物。该疾病预后良好。

Objective To analyze the clinic features of eosinophilic gastroenteritis and examine the diagnosis,treatment,long-term outcome of this disease.Methods We retrospectively analyze the history of disease,the clinical manifestations,laboratory,endoseopic,pathologica finding,treatment,and clinical outcome in 14 patients who were diagnosed as eosinophilic gastroentcritis.Results 14 patients had predominant involvement 10 of mucosa,1 of musularis,and 3 of subserosa.All patients had different levels gastrointestinal symptoms,and all patients have confirmed eosinophilic infiltration of the gastrointestinal tissues by endoscopic or surgical biopsy.9 patient were treated with oral prednisolone,the symptoms subsided within 1～2 weeks,and the eosinophil count decreased to normal level.The prognosis is well.Conclusion Eosinophilic gastroenteritis is a rare disease of unclear etiology and pathogensis.Definitive diagnosis requires histological evidence of eosinophilic infiltration by endoscopic biopsy or operative.Steroids remain the mainstay of therapy for eosinophilic gastroentetitis,and the prognosis is well.