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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,目录,目录,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,嗜酸细胞性胃肠炎的临床表现及病理学形态特征分析,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。,嗜酸细胞性胃肠炎36 例临床分析,研究一,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,19952008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,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,。,症状,以腹痛、腹泻、恶心呕吐为主,无肠外症状。,多数患者外周血嗜酸细胞,计数升高,。,研究结果,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。,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。,蔡召强,王爱英,吕愈敏. 嗜酸细胞性胃肠炎36例临床分析J. 中国内镜杂志,2010,02:135-139.,Eosinophilicgastroenteritis:clinicalmanifestationsandmorphologicalcharacteristics, aretrospectivestudyof42,patients,Study Two,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,theclinicalmanifestations, endoscopic, and radiologicalcharacteristics, histological features, and treatment ofeosinophilicgastroenteritisin adultpatients.,METHODS,Theclinicalrecords of,34,patientsdiagnosed aseosinophilicgastroenteritisand,eight,patientswho had abdominal symptoms and unexplained peripheral eosinophilia but no evidence of tissueeosinophilicinfiltration were,reviewed and analyzed,.,RESULTS,Thirteenpatientshad 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,2,-macroglobulin,was elevated in 92.8% ofpatients.,The,small intestine,(82.4%)was the most common site involved.,RESULTS,Erythema,was the predominate feature seen on endoscopy.,Radiographicstudygenerally revealed,thickening,of the small intestinal wall.,Eosinophilia generally involved the,lamina propria of mucosa, but any layer of the gut could be affected, even in sites which had normal endoscopic or radiographic appearance.,RESULTS,In all, 15.4% (6/39) ofpatientshad,Helicobacter pylori infection,.,Symptom remission within 1 week was found in 80% (20/25) ofpatientstreated with,steroids,and in 58.8% (10/17) ofpatientstreated with,symptomatic treatment,.,In all, 85.7% (18/21) ofpatientshad their eosinophil counts return to normal within 2 weeks in the,steroid treatment,group, but none (0/13) in the other group.,CONCLUSION,Eosinophilicgastroenteritismay be,more common,than previously recognized.,Multiple biopsies,obtained from the both normal and abnormal appearing areas in the second part of the duodenum are,highly recommended,.,Steroids,are effective in relieving symptoms and improving eosinophilia.,Zhang L, Duan L, Ding S, Lu J, Jin Z, Cui R, McNutt M, Wang A.,Eosinophilic gastroenteritis: clinical manifestations and morphological,characteristics, a retrospective study of 42 patients.,Scand J Gastroenterol. 2011 Sep;46(9):1074-80.,Thanks for your attention!,
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