15例嗜酸细胞性胃肠炎的临床和内镜表现

Clinical and Endoscopic Findings Eosinophilic Gastroenteritis

目的嗜酸细胞性胃肠炎（eosinophilic gastroenteritis，EG）临床罕见，经常漏诊、误诊，本文通过分析所收集病例的临床和内镜表现，希望提高临床医生对本病的认识。方法选择首都医科大学附属北京友谊医院2004—2012年住院治疗的患者共15例，针对患者的发病过程、临床症状体征、化验结果、内镜诊断、临床治疗进行总结、分析，结合文献探讨该病的诊断、治疗。结果EG患者以腹痛、腹泻为主要症状，部分患者可出现腹胀、腹水，外周血嗜酸细胞比例达16％。68％，骨穿可见嗜酸粒细胞明显升高，腹水化验可见大量嗜酸细胞，内镜检查可见胃窦、十二指肠、结肠黏膜水肿、糜烂、溃疡形成，病理检查证实嗜酸细胞浸润，一般给予激素治疗，可迅速缓解临床症状，并使外周血嗜酸粒细胞明显下降或恢复正常。结论EG临床和内镜表现无特异性，但内镜检查是主要诊断手段，病理诊断是关键。

Objective Eosinophilic gastroenteritis（EG） was a rare disease,it was misdiagnosed frequently in clinic,the clinical and endoscopic findings of the disease were collected and analyzed,we hope to improve clinician awareness of this disease. Methods From 2004 to 2012 ,a total of 15 cases of hospitalized patients in Beijing Friendship Hospital,Capital Medical Univer- sity were enrolled, the disease process for patients, clinical symptoms and signs, laboratory results, endoscopic diagnosis and clini- cal treatment were summarized and analyzed. Results Abdominal pain and diarrhea were the main symptoms of EG patients, some patients may appear bloating, ascites, peripheral blood eosinophil ratio reached 16% -68%, and visible eosinophilia, ascites can be detected in a large number of eosinophils, endoscopy showed gastric antrum, duodenum, colon mucosa edema, erosion and ulceration, pathologic examination confirmed eosinophils, generally given hormone therapy, symptoms can be relieved quickly, and peripheral blood eosinophils decreased or returned to normal. Conclusion EG had nonspecific clinical and endoscopic findings, but endoscopy was the primary diagnostic tool, pathological diagnosis was the key.