嗜酸细胞性胃肠炎合并2型糖尿病2例临床分析..doc

嗜酸细胞性胃肠炎合并2型糖尿病2例临床分析 】目的探讨嗜酸细胞性胃肠炎合并2型糖尿病 2例临床特点和治疗。方法检索我院1999?XX年共收治2例 嗜酸细胞性胃肠炎合并2型糖尿病患者，对他们的临床特点、 实验室检查、内镜表现和治疗随访情况进行系统分析。结果 患者的临床表现多样，包括腹痛、腹泻、腹胀、恶心、呕吐、 低热及体重下降等糖尿病酮症的表现；临床症状的缓解随酮 症的纠正和血糖控制理想而缓解；外周血和骨髓中嗜酸细胞 计数随着症状的缓解而下降；内镜下表现多为黏膜糜烂和水 肿，累及全胃，缺乏特异性，以胃窦和回盲部最常受累，活 检可见大量嗜酸细胞浸润；激素、胰岛素应用为治疗的一线 药物，可迅速缓解症状，并使嗜酸细胞恢复正常；病情反复 复发的患者可考虑延长激素的治疗时间、长期应用胰岛素或 免疫抑制剂。结论嗜酸细胞性胃肠炎合并2型糖尿病在诊断 上极易造成误诊，最后的诊断需要依靠活组织检查来证实。 关键词】胃肠炎；嗜酸细胞；2型糖尿病；临床特 点；治疗 Clinicalanalysisontwopatientswitheo Clinicalanalysiso ntwopatientswitheo sinophilicgastroen teritiscombinedwit htype2diabetes [Ab stract ] Objective Tostudythee1 inical characteristicsandtreatmentoftwopati characteristicsand treatmentoftwopati entswitheosinophil ombinedwithtype2 T switheosinophilicg inedwithtype2diabe oml999toXX,whosecl ics,labtest,endosc mentandfollowingupicgastroenteritisc hereweretwopat i entastroenteritiscomb entswitheosinophil ombinedwithtype2 T switheosinophilicg inedwithtype2diabe oml999toXX,whosecl ics,labtest,endosc mentandfollowingup icgastroenteritisc hereweretwopat i ent astroenteritiscomb tesinourhospitalfr inicalcharacterist opicfeatures,treat weresystemically C 1 inicalcharacteris ticsincludedabdomi nalpain ， diarrhea,a bdominaldistension ,nausea , vomiting,1 owheatandwEight, ch aracteristicsympto mrelievedwithreetificationofketosisa mrelievedwithreeti ficationofketosisa ndideallycontrolli countsofacidophi11 marrowdroppedwi tht ngofbloodsugarTheeukocyteinbloodand hereliefofsymptom；Endoscopicfeatures concludedmucosaler osionandhydrops in volvedthewholestom ach ， lackofspecific ity ， gastricantruma ndileocecumweremor einvaded，lotsofaci ngofbloodsugar The eukocyteinbloodand hereliefofsymptom； moneoenteritiswhichcoapidlyandreduceac iuldrelievesymptomr dophilleukocytetondophi1leukocyteswe reseeninbiopsy；Hor insulinwereth efirstchoicetotrea teosinophiliegastr mone oenteritis whichco apidlyandreduceac i uldrelievesymptomr dophilleukocyteton thepatientsshoul dadoptmoretreatmen ttime ， useinsulinlo ngtimeoruseimmuno- su