嗜酸细胞性胃肠炎合并糖尿病2例临床剖析.docVIP

嗜酸细胞性胃肠炎合并糖尿病2例临床剖析 　　【摘要】 目的 探讨嗜酸细胞性胃肠炎合并糖尿病2例临床特点和治疗。方法 检索我院1999～2007年共收治2例嗜酸细胞性胃肠炎合并糖尿病患者，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 （1）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；（2）外周血和骨髓中嗜酸细胞计数随着症状的缓解而下降；（3）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；（4）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；（5）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 糖尿病 临床特点 治疗 　　 　　Clinical Analysis on Two Patients with Eosinophilic Gastroenteritis Combined with Type. Zhu xin.He ze City Hospital,Heze 274031,Shandong,China. 　　【Abstract】Objective To study the clinical characteristics and treatment of two patients with eosinophilic gastroenteritis combined with type.Methods There were two patients with eosinophilic gastroenteritis combined with type in our hospital from 1999 to 2007,whose clinical characteristics,lab test,endoscopic features,treatment and following up were systemically analyzed.Results （1）Clinical characteristics included abdominal pain，diarrhea,abdominal distension,nausea，vomiting,low heat and weight,etc.Clinical characteristic symptom relieved with rectification of ketosis and ideally controlling of blood sugar；（2）The counts of acidophil leukocyte in blood and marrow dropped with the relief of symptom ;（3） Endoscopic features concluded mucosal erosion and hydrops，involved the whole stomach，lack of specificity，gastric antrum and ileocecum were more invaded，lots of acidophil leukocytes were seen in biopsy;（4）Hormone，insulin were the first choice to treat eosinophilic gastroenteritis，which could relieve symptom rapidly and reduce acidophil leukocyte to normal;（5）If the diseases recur again and again，the patients should adopt more treatment time，use insulin long time or use immuno-suppressive agent.Conclusion Eosinophilic gastroenteritis is misdiagnosed easily.The confirmed diagnosis depends on biopsy. 　　【Key words】Gastroenteritis;Acidophil leukocyte;Type 2 diabetes;Clinical characteristics;Trea