嗜酸細(xì)胞性胃腸炎的臨床表現(xiàn)及病理學(xué)形態(tài)特征分析

1、目錄目錄嗜酸細(xì)胞性胃腸炎的臨床表現(xiàn)及病理學(xué)嗜酸細(xì)胞性胃腸炎的臨床表現(xiàn)及病理學(xué)形態(tài)特征分析形態(tài)特征分析目錄目錄簡(jiǎn)介簡(jiǎn)介n嗜酸細(xì)胞性胃腸炎（EG）是一種少見(jiàn)胃腸道疾病。KLEIN 等人按嗜酸細(xì)胞浸潤(rùn)程度及部位提出該病分型，OYAIZU 等提出過(guò)敏機(jī)制。TALLEY 等人總結(jié)分析擬出嗜酸細(xì)胞性胃腸炎的診斷標(biāo)準(zhǔn)，現(xiàn)被廣泛采用。目錄目錄嗜酸細(xì)胞性胃腸炎嗜酸細(xì)胞性胃腸炎36 例臨床分析例臨床分析研究一研究一目錄目錄研究目的研究目的n探討嗜酸細(xì)胞性胃腸炎的臨床特征及診斷方法。目錄目錄研究方法研究方法n收集北京大學(xué)第三醫(yī)院消化內(nèi)科19952008年收治的嗜酸細(xì)胞性胃腸炎患者36例，對(duì)其一般情況、臨床癥狀、實(shí)驗(yàn)

2、室檢查、消化道造影、內(nèi)鏡及病理表現(xiàn)和治療隨訪等情況進(jìn)行系統(tǒng)性回顧分析、總結(jié)。目錄目錄研究結(jié)果研究結(jié)果n嗜酸細(xì)胞性胃腸炎多呈急性或亞急性病程,多有過(guò)敏性疾病病史或飲食的誘發(fā)因素。n癥狀以腹痛、腹瀉、惡心嘔吐為主,無(wú)腸外癥狀。n多數(shù)患者外周血嗜酸細(xì)胞計(jì)數(shù)升高。目錄目錄研究結(jié)果研究結(jié)果n內(nèi)鏡下主要為炎性改變,活檢部位以小腸特別是十二指腸檢出率較高,病理示胃腸道組織以大量嗜酸細(xì)胞為主的炎性細(xì)胞浸潤(rùn),其中統(tǒng)計(jì)小腸嗜酸細(xì)胞38/HP。n治療首選皮質(zhì)激素,抗過(guò)敏、飲食調(diào)整有效。目錄目錄目錄目錄結(jié)論結(jié)論n臨床懷疑嗜酸細(xì)胞性胃腸炎時(shí)應(yīng)在內(nèi)鏡或造影檢查時(shí)行多部位活檢，即使內(nèi)鏡和造影觀察正常,也應(yīng)進(jìn)行黏膜活檢，十二

3、指腸是活檢的關(guān)鍵部位，空腸活檢亦能提高其診斷率。目錄目錄蔡召?gòu)?qiáng)蔡召?gòu)?qiáng),王愛(ài)英王愛(ài)英,呂愈敏呂愈敏. 嗜酸細(xì)胞性胃腸炎嗜酸細(xì)胞性胃腸炎36例臨床分析例臨床分析J. 中國(guó)內(nèi)鏡雜志中國(guó)內(nèi)鏡雜志,2010,02:135-139.目錄目錄Eosinophilic gastroenteritis: clinical manifestations and morphological characteristics, a retrospective study of 42 patientsStudy Two目錄目錄IntroductionIntroductionnEosinophil associated g

4、astrointestinal disorders (EGIDs), including eosinophilic esophagitis (EE) and eosinophilic gastroenteritis (EGE), are a spectrum of inflammatory diseases which are recognized with increasing frequency, characterized by eosinophilic infiltration of the gastrointestinal (GI) tract with varying GI sym

5、ptoms. 目錄目錄IntroductionIntroductionnThere are various clinical manifestations associated with this disease which range from conditions requiring surgery to remitting discomfort over long periods.nEndoscopic and radiographic findings may vary from normal to slightly abnormal and cases may show diffus

6、e abnormalities.目錄目錄IntroductionIntroductionnIn some cases, histological specimens are difficult to obtain, and as a result there are many instances of misdiagnosis or missed diagnosis of EGE in clinical practice. 目錄目錄OBJECTIVEOBJECTIVEnTo evaluate the clinical manifestations, endoscopic, and radiol

7、ogical characteristics, histological features, and treatment of eosinophilicgastroenteritis in adult patients.目錄目錄METHODSMETHODSnThe clinical records of 34 patients diagnosed as eosinophilic gastroenteritis and eight patients who had abdominal symptoms and unexplained peripheral eosinophilia but no

8、evidence of tissue eosinophilic infiltration were reviewed and analyzed.目錄目錄RESULTSRESULTS1.Thirteenpatientshadahistoryofasthmaorallergicrhinitis,while10hadanallergichistory.2.Peripheraleosinophiliaoccurredin83.3%ofpatients,IgEwaselevatedinhalf,and2-macroglobulinwaselevatedin92.8%ofpatients.3.Thesma

9、llintestine(82.4%)wasthemostcommonsiteinvolved.目錄目錄RESULTSRESULTS4.Erythemawasthepredominatefeatureseenonendoscopy.5.Radiographicstudygenerallyrevealedthickeningofthesmallintestinalwall.6.Eosinophiliagenerallyinvolvedthelaminapropriaofmucosa,butanylayerofthegutcouldbeaffected,eveninsiteswhichhadnorm

10、alendoscopicorradiographicappearance.目錄目錄RESULTSRESULTS7.Inall,15.4%(6/39)ofpatientshadHelicobacterpyloriinfection.8.Symptomremissionwithin1weekwasfoundin80%(20/25)ofpatientstreatedwithsteroidsandin58.8%(10/17)ofpatientstreatedwithsymptomatictreatment.9.Inall,85.7%(18/21)ofpatientshadtheireosinophil

11、countsreturntonormalwithin2weeksinthesteroidtreatmentgroup,butnone(0/13)intheothergroup.目錄目錄目錄目錄目錄目錄目錄目錄目錄目錄CONCLUSIONCONCLUSIONnEosinophilicgastroenteritismaybemorecommonthanpreviouslyrecognized.nMultiplebiopsiesobtainedfromthebothnormalandabnormalappearingareasinthesecondpartoftheduodenumarehighlyrecommended.nSteroidsareeffectiveinrelievingsymptomsandimprovingeosinophilia.目錄目錄Zhang L, Duan L, Ding S, Lu J, Jin Z, Cui R, McNutt M, Wang A. Eosinophilic gastroe