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目的探讨嗜酸细胞性胃肠炎(EG)的诊断要点和治疗预后。方法对7例EG患者的临床特点、实验室检查、内镜表现和治疗随诊情况进行分析。结果(1)粘膜型EG患者常以腹痛和腹泻为首发症状,而浆膜型以腹痛和腹胀为首发症状,可伴恶心呕吐、低热等。(2)外周血和骨髓中嗜酸细胞计数明显增高(45.0%±22.4%和35.5%±2.6%),以成熟型为主,并随症状的有无而增减。(3)血沉、C反应蛋白、纤维蛋白原等指标正常,IgG可下降。(4)腹水为渗出液,可见嗜酸细胞。(5)内镜表现多为粘膜片状糜烂和水肿,以胃窦和回盲部明显,活检可证实大量嗜酸细胞浸润。(6)激素可在1周内迅速缓解症状,并使嗜酸细胞恢复正常。(7)病情可有反复,但预后良好。结论EG临床和内镜表现无特异性,外周血嗜酸细胞、腹水嗜酸细胞,尤其是胃肠粘膜组织中嗜酸细胞增多是诊断的关键。
Objective To investigate the diagnosis and prognosis of eosinophilic gastroenteritis (EG). Methods The clinical features, laboratory tests, endoscopic findings and follow-up of 7 patients with EG were analyzed. Results (1) Patients with mucosal EG usually have abdominal pain and diarrhea as the first symptom, while serosalgia with abdominal pain and abdominal distension as the first symptom can be associated with nausea, vomiting and fever. (2) Peripheral blood and bone marrow eosinophil count was significantly higher (45.0% ± 22.4% and 35.5% ± 2.6%), mainly in mature type, and with the presence or absence of symptoms increase or decrease. (3) erythrocyte sedimentation rate, C-reactive protein, fibrinogen and other indicators of normal, IgG can be decreased. (4) ascites as exudate, visible eosinophils. (5) Endoscopic showed mostly mucosal lamellar erosion and edema, obvious to the antrum and ileocecal biopsy can confirm a large number of eosinophilic infiltration. (6) hormones can quickly relieve symptoms within 1 week, and make eosinophil return to normal. (7) The condition may be repeated, but the prognosis is good. Conclusion EG has no specific clinical and endoscopic findings. Eosinophils in peripheral blood, ascites in ascites, especially in gastrointestinal mucosa are the key to diagnosis.