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1、临床内科杂志2008年6月第25卷第6期JClinInternMed,June2008,Vo,l25,No.6#413##论著#20例嗜酸性粒细胞性胃肠炎临床及内镜特点分析黄焕军刘瑶刘南植田德安[中图分类号]R573.3[文献标识码]A[文章编号]1001-9057(2008)06-0413-03[摘要]目的探讨嗜酸性粒细胞性胃肠炎(EG)患者的临床表现及内镜检查对该病的诊治价值。方法对20例EG患者的临床特点、试验室检查、内镜表现和治疗随诊情况进行分析。结果20例患者中黏膜型12例、浆膜型2例、混合型6例;EG临床表
2、现以腹痛为主,可伴有腹胀、腹泻、腹水、恶心、呕吐;外周血和骨髓中嗜酸性粒细胞计数明显增多(13.5%~50.6%和7.8%~38.5%),腹水中可见大量嗜酸性粒细胞;内镜表现为黏膜充血水肿、糜烂,病理检查可见大量嗜酸性粒细胞浸润;糖皮质激素治疗1~2周内可迅速缓解症状,减量维持,然后逐渐减量至停药;病情可反复,但预后良好。结论EG患者临床和内镜表现无特异性,外周血和腹水中嗜酸性粒细胞计数明显增多,胃肠黏膜组织中嗜酸性粒细胞浸润是诊断的关键,糖皮质激素治疗效果良好。[关键词]嗜酸性粒细胞性胃肠炎;内镜/诊断;治疗Clin
3、icalandendoscopicfeaturesin20casesofeosinophilicgastroenteritisHuangHuanjun,LiuYao,LiuNanzhi,etal.DepartmentofGastroenterology,TongjiHospital,TongjiMedicalCollege,HuazhongUniversityofScienceandTechnology,Wuhan430030,China[Abstract]ObjectiveToevaluatethevalueofcl
4、inicalmanifestationsandendoscopyinthediag-nosisofeosinophilicgastroenteritis.Methods20caseswitheosinophilicgastroenteritiswereanalyzedre-trospectivelyinclinicalcharacteristics,labaoratorytests,endoscopicmanifestations,treatmentandprogno-sis.ResultsInallthepatien
5、tswitheosinophilicgastroenteritis,12ofthemwerepredominantmucosaltype,2wrereserosaltypeand6weremusculartype.Themainmanifestationsofpatientswitheosinophilicgastroenteritiswereabdominalpain,whichcoupledwithbloating,diarrhea,ascites,nauseaandvomiting;theeosinophilic
6、countsinperipheralbloodandbonemarrowofallthepatientswithEGwerehigh.Thepro-portionsofeosinophiliccellsinperipheralbloodandbonemarrowwere13.5%-50.6%and7.8%-38.5%,respectively;theasciteswasassociatedwitheosinophilsintheperitonealfluid;endoscopyshowedhyperaemia,edem
7、aanderosioningastroenterologicmucosa.Themucosawasinfiltratedwitheosinophils.Thesteroidhormonetherapeuticresponsewasgood;allsympotomswererelievedwithinonetotwoweeks;thedoseofthetherapywastaperedgraduallyandstopped.Symptomscouldrecurbuttheprognosisisgood.Conclusio
8、nTheclinicalandendoscopicmanifestationsofthepatientswitheosinophilicgastroen-teritishadnospecificcharacteristics.Theenosinophiliccountsinperipheralbloodandasciteswere
