嗜酸性粒细胞性胃肠炎1例报道并文献复习.pdf

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1、762JBengbuMedCoil，June2015，Vol40，No．6[文章编号]1000-2200(2015)06-0762-04·临床医学·嗜酸性粒细胞性胃肠炎1例报道并文献复习刘威，倪陈[摘要】目的：总结嗜酸性粒细胞胃肠炎(EG)的分型、临床表现、诊断及治疗方法。方法：1例以反复出现消化道症状入院患儿，人院后完善相关检查，排除寄生虫感染、血液系统肿瘤等疾病，确诊为EG，给予抗过敏药物、白三烯抑制剂及皮质激素治疗。观察患儿临床症状缓解及消失、实验室指标恢复正常的时间。结果：EG有反复出现呕

2、吐、腹痛、腹泻等消化道症状，甚至出现吞咽困难、肠梗阻、肠穿孔；实验室检查：外周血嗜酸性粒细胞升高；内镜检查：黏膜粗糙、充血水肿，点片状红斑或糜烂；活组织病理检查：病变部位每高倍视野超过15～20个嗜酸性粒细胞。皮质激素等治疗后，实验室指标逐渐恢复正常，临床症状好转直至消失。结论：EG是一种胃肠道变态反应性良性疾病，皮质激素治疗有效。[关键词]胃肠炎；嗜酸性粒细胞；呕吐；腹泻[中图法分类号]R573．7[文献标志码】ADOI：10．13898／j．cnki．issn．1000-2200．2015．0

3、6．021TheeosinophilicgastroenteritiscomplicatedinacaseandliteraturereviewLIUWei，NIChen(DepartmentofPediatrics，AnhuiProvincialHospitalAfiliatedtoAnhuiMeScalUniversity，HefeiAnhui230001，China)[Abstract]0bjective：Tosummarythegenotyping，clinicalmanifestatio

4、ns，diagnosisandclinicaltreatmentofeosinophilgastroenteritis(EG)．Methods：OneEGchildwithrecurrentgastrointestinalsymptoms，excludingparasiticinfections，bloodsystemcancerandotherdiseases，wasdignosedbyexamination，whowastreatedwithanti—allergicdrugs，leukotr

5、ieneinhibitorandcorticosteroid．Thetimeofclinicalsymptomsremissionanddisappear，andlaboratoryindexrecoverywereobserved．Results：Therecurrentvomiting，abdominalpain，diarrheaandothergastrointestinalsymVoms，evendysphagia，intestinalobstructionandintestinalper

6、foration，weretheclinicalfeaturesofEG．Thelaboratorytestshowedthateosinophiliagranulocyteofperipheralbloodincreased．Theroughmucosalcongestionandedema，andpointflakeerythemaorerosionwerefoundbyendoscopicexamination．Fifteentotwentyeosinophilsperhighpowerfi

7、eldofthelesionwereidentifiedbypathologyexamination．Thelaboratoryparametersreturnedtonormallevel，andclinicalsymptomsimprovedordisappearedaftertreatment．Conclusions：EGisagastrointestinalallergicbenigndisease，theeffectofwhichtreatedwithcorticosteroidisef

8、fective．[Keywords]gastroenteritis；eosinophils；vomit；diarrhea嗜酸性粒细胞性胃肠炎(eosinophilic未见好转，转至当地县医院就诊，检查血常规示gastroenteritis，EG)是一种比较少见的良l生胃肠道疾病，WBC及中性粒细胞计数均升高，腹部立位平片示肠临床报道较少，诊断较难，且易误诊、漏诊。本文在梗阻，给予输液及灌肠治疗4d，呕吐症状好转，但腹我院确诊的1例就其分型、临床表现、诊断及治疗等泻、腹胀较前加重，转