儿童嗜酸性粒细胞胃肠炎的临床特征分析

Clinical characteristics of young children with eosinophilic gastroenteritis

目的研究儿童嗜酸性粒细胞胃肠炎(eosinophilic gastroenteritis,EGE)的临床特征和治疗反应。方法回顾性分析75例EGE患儿的临床症状、变应原致敏谱、部分检验指标,以及治疗后反应。结果在75例患儿中,EGE的典型症状有反流症状(89.33%)、呕吐(90.67%)、腹泻(49.33%)、液体吞咽困难(52.00%)和便秘(46.67%),各年龄段患儿出现上述临床症状的概率差异均无统计学意义(均P<0.05)。腹泻在0~1岁患儿的发生率(83.33%)相比其他年龄组更高,也更容易因为病情导致生长迟滞(83.33%);而2~3岁患儿更容易有哮喘症状(72.22%)。从门诊病情上看,2~3岁患儿容易体现为胃肠炎症状(94.44%);4~6岁患儿容易体现为过敏症状(89.47%),上述差异均有统计学意义(均P<0.05)。最常见的环境过敏原是动物皮屑(12.00%),食物过敏原是鸡蛋(29.33%)。在75例患儿中,有34.67%的患儿出现明显贫血,29.33%的患儿出现明显或隐匿性便血,74.67%的患儿出现显著的外周血免疫球蛋白E水平增高。经过治疗后,有68例患儿(90.67%)的临床症状有所改善,在完成至少4个疗程治疗后,有41例患儿(54.66%)食管上皮嗜酸性粒细胞(eosinocyte,EOS)浸润水平<15 EOS/HPF。结论EGE患儿有反流、呕吐、腹泻、液体吞咽困难和便秘等临床特征,治疗反应中84.00%的患儿在活检中显示出组织学反应,EOS水平显著降低。

Objective To study the clinical features and treatment response of eosinophilic gastroenteritis(EGE)in children.Methods The clinical symptoms,allergen sensitization spectrum,some test indexes,and post-treatment reactions of 75 children with EGE were retrospectively analyzed.Results Among the 75 children,the typical symptoms of EGE were reflux symptoms(89.33%),vomiting(90.67%),diarrhea(49.33%),fluid swallowing difficulties(52.00%),and constipation(46.67%).There were no significant differences in the probability of developing these clinical symptoms among children of all ages(all P<0.05).The incidence of diarrhea in children aged 0-1(83.33%)was higher than that in other age groups,and they were more likely to cause growth retardation(83.33%),while children aged 2-3 were more likely to have asthma symptoms(72.22%).From the perspective of outpatient conditions,children aged 2-3 years were more likely to have gastroenteritis(94.44%);children aged 4-6 years were more likely to have allergic symptoms(89.47%),and the above differences were all statistically significant(P<0.05).The most common environmental allergen was animal dander(12.00%),and the food allergen was eggs(29.33%).Among the 75 children,34.67%had evident anemia,29.33%had obvious or occult blood in the stool,and 74.67%had significantly increased peripheral blood immunoglobulin E levels.After treatment,68 children(90.67%)showed clinical improvement and 41 children(54.66%)had an esophageal epithelial eosinocyte(EOS)infiltration level<15 EOS/HPF after completing at least 4 courses of treatment.Conclusion Children with EGE have symptoms such as reflux,vomiting,diarrhea,fluid dysphagia,and constipation.84.00%of the children who responded to treatment showed a histological response in the biopsy,and eosinophil levels were significantly reduced.