蛋白丢失性肠病临床特点分析

Analysis of clinicopathological characteristics of protein-losing enteropathy

目的:探讨蛋白丢失性肠病(PLE)病人的临床病理特点,为临床诊治提供参考。方法:回顾性分析2010年10月至2019年10月期间于郑州大学第一附属医院就诊的15例经99mTc标记白蛋白显像确诊的PLE病人的临床病理资料。结果:15例PLE病人中,男5例,女10例,年龄5岁~78岁(46.33±21.21)岁。水肿为常见的临床表现。根据影像学检查,合并浆膜腔积液11例。原发病主要为系统性红斑狼疮7例,此外有1例未分化结缔组织病,1例肠结核。严重低蛋白血症、高甘油三酯血症、低钙血症、补体C3降低、CD4^+/CD8^+T淋巴细胞比例降低对蛋白丢失性肠病的诊断有一定意义。结论:蛋白丢失性肠病以低蛋白血症、水肿、多浆膜腔积液为主要表现。99mTc标记白蛋白显像是诊断蛋白丢失性肠病的重要方法。治疗以治疗原发病为主,糖皮质激素、免疫抑制剂、肝素、奥曲肽、钙剂等可能对疾病治疗有效。

Objective:To investigate the clinicopathological characteristics of patients with protein-losing enteropathy(PLE)and provide reference for clinical diagnosis and treatment.Methods:The clinical and pathological data of 15 patients with PLE diagnosed by99 mTc-labeled albumin imaging at the First Affiliated Hospital of Zhengzhou University from October 2010 to October 2019 were retrospectively analyzed.Results:Among the 15 patients with PLE,5 were male and 10 were female,with the ages ranged from 5 to 78 years(46.33±21.21 years).Edema was a common clinical manifestation.According to imaging examination,11 cases of serous effusion were complicated.The primary disease was mainly systemic lupus erythematosus(n=7),and other primary diseases included 1 case of undifferentiated connective tissue disease and 1 case of intestinal tuberculosis.Severe hypoproteinemia,hypertriglyceridemia,hypocalcemia,decreased levels of C3,and decreased CD4^+/CD8^+T lymphocyte ratio have a certain significance in the diagnosis of PLE.Conclusion:PLE is mainly characterized by hypoproteinemia,edema,and multiple serous effusion.99mTc-labeled albumin imaging is an important method for its diagnosis.Treatment of primary disease is the mainly approach,and glucocorticoids,immunosuppressive agents,heparin,octreotide,calcium,etc.may be effective for the treatment.