嗜酸细胞性胃肠炎临床表现及病理学形态特征分析.pptVIP

简介 嗜酸细胞性胃肠炎（EG）是一种少见胃肠道疾病。KLEIN 等人按嗜酸细胞浸润程度及部位提出该病分型，OYAIZU 等提出过敏机制。TALLEY 等人总结分析拟出嗜酸细胞性胃肠炎的诊断标准，现被广泛采用。 研究目的 探讨嗜酸细胞性胃肠炎的临床特征及诊断方法。 研究方法 收集北京大学第三医院消化内科1995～2008年收治的嗜酸细胞性胃肠炎患者36例，对其一般情况、临床症状、实验室检查、消化道造影、内镜及病理表现和治疗随访等情况进行系统性回顾分析、总结。 研究结果 ①嗜酸细胞性胃肠炎多呈急性或亚急性病程,多有过敏性疾病病史或饮食的诱发因素。 ②症状以腹痛、腹泻、恶心呕吐为主,无肠外症状。 ③多数患者外周血嗜酸细胞计数升高。 研究结果 ④内镜下主要为炎性改变,活检部位以小肠特别是十二指肠检出率较高,病理示胃肠道组织以大量嗜酸细胞为主的炎性细胞浸润,其中统计小肠嗜酸细胞≥38/HP。 ⑤治疗首选皮质激素,抗过敏、饮食调整有效。 结论 临床怀疑嗜酸细胞性胃肠炎时应在内镜或造影检查时行多部位活检，即使内镜和造影观察正常,也应进行黏膜活检，十二指肠是活检的关键部位，空肠活检亦能提高其诊断率。? Introduction Eosinophil associated gastrointestinal 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 symptoms. Introduction There are various clinical manifestations associated with this disease which range from conditions requiring surgery to remitting discomfort over long periods. Endoscopic and radiographic findings may vary from normal to slightly abnormal and cases may show diffuse abnormalities. Introduction In 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. OBJECTIVE To evaluate the?clinical?manifestations, endoscopic, and radiological?characteristics, histological features, and treatment of?eosinophilicgastroenteritis?in adult?patients. METHODS The?clinical?records of 34?patients?diagnosed as?eosinophilic?gastroenteritis?and eight?patients?who had abdominal symptoms and unexplained peripheral eosinophilia but no evidence of tissue?eosinophilic?infiltration were reviewed and analyzed. RESULTS Thirteen?patients?had a history of asthma or allergic rhinitis, while 10 had an allergic history. Peripheral eosinophilia occurred in 83.3% ofpatients, IgE was elevated in half, and α2-macroglobulin was elevated in 92.8% of?patien