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  • 谭炜,时培美,曾欣,谢渭芬.嗜酸细胞性胃肠炎患者17例的临床特点和预后分析[J].第二军医大学学报,2018,39(2):207-211    [点击复制]
  • TAN Wei,SHI Pei-mei,ZENG Xin,XIE Wei-fen.A retrospective analysis of clinical characteristics and prognosis of 17 patients with eosinophilic gastroenteritis[J].Acad J Sec Mil Med Univ,2018,39(2):207-211   [点击复制]
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嗜酸细胞性胃肠炎患者17例的临床特点和预后分析
谭炜,时培美,曾欣,谢渭芬*
0
(第二军医大学长征医院消化内科, 上海 200003
*通信作者)
摘要:
目的 分析嗜酸细胞性胃肠炎(EG)患者的临床特点和预后情况,为该病的早期诊断和治疗提供依据。方法 回顾性分析2009年7月至2017年1月第二军医大学长征医院确诊的17例EG患者的临床资料。结果 EG患者男性多于女性,男女比例为2.4:1,其中52.9%(9/17)的患者既往有过敏史。临床表现主要为腹痛(76.5%,13/17),其次为腹胀(41.2%,7/17)。所有患者外周血嗜酸粒细胞计数均升高;内镜检查示病变主要位于胃窦、胃体和十二指肠降部,可见黏膜充血糜烂。病理活组织检查(13例)和(或)腹水检查(5例)见嗜酸粒细胞浸润。8例患者行腹部CT检查,均见胃壁或局部小肠壁水肿增厚,肠系膜增厚。糖皮质激素是治疗EG的主要方案,可有效缓解症状。获得随访资料者13例,其中7例复发,复发率为53.8%(7/13),复发后再次用糖皮质激素仍然有效。结论 EG临床表现缺乏特异性,内镜下多点活组织检查是诊断的关键,糖皮质激素可有效缓解症状并降低外周血嗜酸粒细胞计数。
关键词:  嗜酸细胞性胃肠炎  诊断  治疗  预后  糖皮质激素
DOI:10.16781/j.0258-879x.2018.02.0207
投稿时间:2017-06-15修订日期:2017-12-29
基金项目:
A retrospective analysis of clinical characteristics and prognosis of 17 patients with eosinophilic gastroenteritis
TAN Wei,SHI Pei-mei,ZENG Xin,XIE Wei-fen*
(Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author)
Abstract:
Objective To analyze the clinical characteristics of eosinophilic gastroenteritis (EG) so as to provide evidence for early diagnosis and treatment of EG. Methods The clinical data of 17 patients with EG, who were admitted to Changzheng Hospital of Second Military Medical University from Jul. 2009 to Jan. 2017, were retrospectively analyzed. Results Male patients had a higher prevalence of EG and occurrence ratio of male and female was 2.4:1. Nine (52.9%) of the 17 patients had a history of allergy. The most common symptoms were abdominal pain (13/17, 76.5%), followed by abdominal distension (7/17, 41.2%). Peripheral eosinophil count elevated in the 17 patients. Endoscopic examination showed that the lesions were mainly located in the gastric antrum, gastric body and descendant duodenum, and the most common finding were mucosal erythema. Biopsy of 13 cases and/or ascites examination of 5 cases showed eosinophil infiltration in the lesions. Abdominal CT scanning of 8 cases showed stomach or partial small bowel wall thickening with edema and thickened mesenterium. Glucocorticoid therapy was the main treatment for EG, and it could effectively relieve the symptoms. Seven of 13 cases who were followed up had relapse, with the recurrence rate being 53.8% (7/13), and were improved after administration of glucocorticoid again. Conclusion The clinical manifestation of EG is non-specific, and the endoscopic multi-point biopsy is the key to diagnose EG. Glucocorticoid can effectively relieve symptoms of EG and reduce peripheral eosinophils count.
Key words:  eosinophilic gastroenteritis  diagnosis  treatment  prognosis  glucocorticoid