嗜酸性粒细胞性胃肠炎151例临床分析

Clinical analysis of 151 cases of eosinophilic gastroenteritis

目的分析嗜酸性粒细胞性胃肠炎(EG)的临床特征及诊疗现状。方法抽取2012年1月至2018年12月郑州大学第一附属医院收治的EG患者151例,回顾性分析其临床资料、内镜表现及复发情况。结果151例中男87例,女64例,年龄11~73岁,病程3 d^20年;黏膜型123例,混合型(累及黏膜层和浆膜层)28例;有过敏史49例(32.45%),有腹痛症状135例(89.4%),嗜酸粒细胞计数高于正常值109例(72.19%)。151例患者内镜表现无特异性,回盲部、十二指肠、回肠末端病理活检阳性率较高,行激素治疗者临床症状缓解时间及嗜酸性粒细胞计数较非激素治疗者下降快。成功随访102例,黏膜型患者复发19例,混合型复发22例。结论嗜酸性粒细胞性胃肠炎多数伴有外周血嗜酸粒细胞的增多,内镜表现无特异性,激素治疗效果好,但存在复发可能,混合型患者较黏膜型更易复发。

Objective To analyze the clinical features and treatment of eosinophilic gastroenteritis(EG).Methods The clinical data,endoscopic features and relapse of 151 patients with EG who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2018 were retrospectively analyzed.Results Among the 151 cases,87 were male and 64 were female,aged 11 to 73 years,with a course of 3 days to 20 years;there were 123 cases of mucosal type and 28 cases of mixed type(involving mucosal layer and serosal layers).Among them,49 patients had a history of allergies(32.45%),135 patients(89.4%)had abdominal pain,and 109 patients(72.19%)had peripheral eosinophilia.The endoscopic features of 151 patients were non-specific,and the positive rates of pathological biopsy at the end of ileocecal,duodenum,and ileum were higher.The remission time of clinical symptoms and the degree of decline in eosiniphil counts in patients treated with hormones was faster than that of the non-hormonal patients.A total of 102 cases were successfully followed up,19 cases of mucosal recurrence and 22 cases of mixed recurrence.Conclusions Most of eosinophilic gastroenteritis is associated with peripheral eosinophilia.The endoscopic features is non-specific.Corticosteroid therapy is effective,but has possibility of recurrence.Patients with mixed type are more likely to relapse than mucosal type.