儿童嗜酸性粒细胞性食管炎

Eosinophilic esophagitis in children

嗜酸性粒细胞性食管炎是一种相对少见的慢性免疫介导的食管疾病,常与过敏性疾病相关,目前病因和病理生理学机制尚不十分明确。临床表现为食管功能障碍,不同年龄症状不尽相同。组织病理学为诊断必需条件,但也需考虑临床表现和质子泵抑制剂反应等。治疗基础是饮食疗法和(或)药物治疗,饮食疗法是儿童一线治疗,可使疾病有效缓解;药物疗法中吞咽氟替卡松或布地奈德局部激素治疗效果显著,然而,目前缺乏长期安全性和有效性数据。对于食管狭窄患儿,必要时需内镜下治疗。而其他治疗药物,如生物制剂、免疫制剂等,须进一步深入研究。

Eosinophilic esophagitis is a relatively rare chronic immune-mediated esophageal disease, which is associated with allergic diseases, and currently its etiology and pathophys- iology mechanism is not yet clear. Clinical manifestations are esophageal dysfunction, and symptoms vary with age. Histopa- thology is necessary for diagnosis, but clinical manifestations and proton pump inhibitor responses also need to be consided. The basis of treatment is dietary therapy and/or drug therapy ; dietary therapy is a first-line treatment for children, which can effectively relieve the disease. Swallowing fluticasone or budesonide local hormone therapy is very effective, however, the data of long-term safety and efficacy are not enough. For esophageal stenosis of EOE children, if necessary, endoscopic treatment may be performed. For other therapeutic agents, such as biological agents and immunological preparations, fur- ther study is needed.