国人嗜酸粒细胞性食管炎38例临床特点的荟萃分析

Meta analysis of 38 patients with eosinophilic esophagitis in China

目的总结国人嗜酸粒细胞性食管炎（EoE）的临床特点及诊治情况，提高临床医生对本病的认识。方法检索1993—2012年发表的关于国人EoE的病例报道，纳入病例需符合以下标准：（1）病历资料相对完整。（2）病例均经内镜活检和／或手术病理确诊。结果共检索到符合要求的文献6篇，包含38例经病理确诊的EoE患者，其中男24例，女14例，发病年龄（47．2±10．9）岁。病程（1．5±1．8）年，主要临床表现为吞咽困难和胸骨后痛，发生率分别为63％（24／38）和58％（22／38）。19例（83％，19／23）有过敏史，20例（80％，20／25）血嗜酸粒细胞升高。病变主要位于食管中下段，内镜下表现以充血、糜烂、黏膜质地脆多见，发现率为47％（18／38），食管黏膜中嗜酸粒细胞的数目（45．8±34．1）个／高倍视野。治疗主要采用糖皮质激素和抑酸药物。结论国人EoE少见，以中年男性为主，慢性病程，吞咽困难和胸骨后痛为常见症状，内镜＋活检组织病理学检查是确诊方法，治疗以糖皮质激素和抑酸药物为主。

Objective To summarize the clinical characteristics and management of eosinophilic esophagitis （EoE） in China and improve the recognition of clinical doctor for this disease. Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients. Data were enrolled according to the admission criterion, which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology. Results Data of 38 patients with EoE from 6 studies were included and analyzed. There were 24 males and 14 females. The age of onset was （47.2 ±10.9）years. The process of the disease was （1.5 ± 1.8 ） years. The main symptoms included dysphagia （24/38, 63% ） and retrosternal pain（22/38,58% ）. Total 19 patients （83%, 19/23） had allergy history and 20 patients （80%, 20/25 ） had elevated blood eosinophil count. Lesions located at the mid-inferior esophagus mainly. Endoscopic manifestation included hyperaemia, erosion and fragile mucosa, and others such as mucosal nodular, ulcer, plaque and white exudates （ 18/38, 47% ）. Eosinophil count in esophageal mucosa was （45.8 ± 34.1 ） numbers/HPF. Main treatment included corticosteroid and acid inhibitory medicine. Conclusions EoE is rare in Chinese people. EoE is more common in middle-aged males with chronic onset. Dysphagia and retrosternal pain is the common symptoms. Endoscopy and biopsy pathology are the methods for definition diagnosis. Corticosteroid and acid inhibitory medicine are the main treatment.