Journal of Internal Medicine Concepts & Practice ›› 2023, Vol. 18 ›› Issue (04): 270-277.doi: 10.16138/j.1673-6087.2023.04.012
• Original article • Previous Articles Next Articles
BAI Yayaa,b, TANG Biwenb, HU Yueliangb, ZUO Junlib, YAO Weiyana()
Received:
2021-12-30
Online:
2023-08-30
Published:
2024-01-09
CLC Number:
BAI Yaya, TANG Biwen, HU Yueliang, ZUO Junli, YAO Weiyan. Clinical characteristics and prognosis of eosinophilic gastroenteritis in 71 cases[J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(04): 270-277.
临床资料 | 黏膜型(n=56) | 肌层型(n=4) | 浆膜型(n=11) | t/Z/χ2 | P |
---|---|---|---|---|---|
临床表现[n(%)] | |||||
腹痛 | 76.8(43/56) | 50.0(2/4) | 72.7(8/11) | 1.441 | 0.487 |
腹胀 | 17.9(10/56) | 25.0(1/4) | 72.7(8/11) | 14.130 | 0.001 |
恶心 | 17.9(10/56) | 25.0(1/4) | 54.5(6/11) | 6.798 | 0.033 |
呕吐 | 23.2(13/56) | 25.0(1/4) | 36.4(4/11) | 0.840 | 0.657 |
腹泻 | 48.2(27/56) | 50.0(2/4) | 27.3(3/11) | 1.670 | 0.434 |
低蛋白血症 | 1.8(1/56) | 0 | 0 | - | - |
症状存在时间[n(%)] | |||||
2周以内 | 14.3(8/56) | 25.0(1/4) | 45.5(5/11) | 5.717 | 0.060 |
2周到半年 | 32.1(18/56) | 25.0(1/4) | 54.5(6/11) | 2.216 | 0.330 |
半年以上 | 53.6(30/56) | 50.0(2/4) | 0 | 0.019 | 1.000 |
实验室检测指标 | |||||
过敏试验阳性[n(%)] | 52.5(21/40) | 25.0(1/4) | 50.0(3/6) | 1.100 | 0.577 |
EOS计数(×109/L) | 1.30(0.38,3.84) | 2.44(0.21,7.55) | 2.10(0.89,8.00) | 2.605 | 0.272 |
EOS直接计数(×109/L) | 2.05(0.45,4.31) | - | 8.60±7.50 | 4.252 | 0.119 |
血清IgE(kU/L) | 143.00(42.55,294.50) | 166.63±146.19 | 258.00(66.90,648.00) | 0.908 | 0.635 |
EOS升高[n(%)] | 90.5(19/21) | 25.0(1/4) | 36.4(4/11) | 13.028 | 0.010 |
IgE升高[n(%)] | 44.4(20/45) | 33.3(1/3) | 55.6(5/9) | 0.566 | 0.754 |
IgA降低[n(%)] | 30.0(12/40) | 33.3(1/3) | 0 | 0.000 | 1.000 |
复发情况[n(%)] | |||||
复发 | 64.4(29/45) | 33.3(1/3) | 66.7(6/9) | 1.226 | 0.542 |
单次复发 | 13.8(4/29) | 0 | 83.3(5/6) | 9.208 | 0.020 |
多次间断复发 | 79.3(23/29) | 1/1 | 16.7(1/6) | 9.340 | 0.007 |
症状持续 | 6.9(2/29) | 0 | 0 | - | - |
复发伴EOS升高的比例[n(%)] | 41.4(12/29) | 25.0(1/4) | 27.3(3/6) | 0.626 | 0.731 |
胃肠镜病理活检 | 平均活检 数目(块) | EOS病理 计数/HPF | 平均活检 部位数(个) |
---|---|---|---|
胃镜活检(n=43) | 2.84±1.98 | 19.63±14.6 | 1.95±1.04 |
食管(n=7) | 1.14±0.38 | 20±0.00 | - |
胃窦(n=42) | 1.52±0.71 | 16.33±17.38 | - |
胃体(n=8) | 1.63±1.06 | - | - |
胃底(n=2) | 1.50±0.71 | - | - |
胃角(n=1) | - | - | - |
十二指肠 | |||
球部(n=12) | 1.17±0.39 | 22.0±12.52 | - |
降部(n=9) | 1.44±0.89 | - | - |
肠镜活检(n=45) | 3.69±2.50 | 27.71±17.07 | 2.44±1.51 |
末端回肠(n=18) | 1.61±1.04 | 34.17±18.55 | - |
回盲部(n=13) | 1.46±1.13 | 31.00±17.45 | - |
升结肠(n=11) | 1.55±0.69 | 35.00±15.00 | - |
横结肠(n=18) | 1.39±0.70 | 22.22±12.78 | - |
降结肠(n=20) | 1.55±0.69 | 20.00±14.14 | - |
乙状结肠(n=24) | 1.29±0.46 | 22.50±21.04 | - |
直肠(n=9) | 1.22±0.44 | 13.33±8.76 | - |
肝区(n=2) | 1.00±0.00 | - | - |
实验室检测指标 | 复发(n=36) | 无复发(n=21) | t/χ2/Z | P |
---|---|---|---|---|
年龄(岁) | 24.08±17.66 | 32.33±26.34 | -1.278 | 0.211 |
外周血EOS计数(×109/L) | 2.24(0.59~4.83) | 1.30(0.38~5.73) | -1.200 | 0.230 |
EOS直接计数(×109/L) | 4.43±3.05 | 0.74±0.85 | 2.871 | 0.010 |
血红蛋白(g/L) | 134.89±18.99 | 127.71±13.86 | 1.510 | 0.137 |
白蛋白(g/L) | 36.97±5.62 | 35.67±8.24 | 0.711 | 0.480 |
ESR(mm/1h) | 5.00(2.00~11.50) | 7.00(0.10~4.15) | -0.341 | 0.773 |
CRP(mg/L) | 2.00(0.43~15.25) | 0.74(0.10~28.00) | -0.537 | 0.591 |
CRP升高比例(%) | 33.3 | 9.5 | 4.058 | 0.044 |
IgG(mg/L) | 10 137.9±2 420.7 | 9 684.0±2 939.2 | 0.525 | 0.603 |
IgG4(mg/L) | 10.4±6.6 | 6.1±5.9 | 1.227 | 0.245 |
IgE(U/mL) | 169.00(71.80~15.25) | 100.00(27.55~354.50) | -1.151 | 0.250 |
IgA(mg/L) | 1 587.9±811.3 | 1 460.7±1 171.9 | 0.401 | 0.691 |
IgM(mg/L) | 1 230.0(912.5~1 447.5) | 1 075.0(682.5~1 742.5) | -1.170 | 0.242 |
Il-2(μg/L) | 616.75±290.42 | 764.63±477.12 | -0.749 | 0.466 |
IL-6(μg/L) | 6.41±5.40 | 4.88±2.57 | 0.759 | 0.459 |
IL-10(μg/L) | 5.00(5.00~11.20) | 5.00(5.00~16.20) | -1.590 | 0.112 |
TNF(pg/mL) | 8.27(5.81~22.40) | 13.50(11.94~24.55) | -0.378 | 0.705 |
菌群调节剂使用(%) | 22.2 | 52.9 | 5.429 | <0.05 |
CRP升高比例(%) | 33.3 | 9.5 | 4.058 | <0.05 |
[1] | Kaijser K. Allergic disease of the gut from the point of view of the surgeon[J]. Arch Klin Chir, 1937, 188: 36-64. |
[2] |
Klein NC, Hargrove RL, Sleisenger MH, et al. Eosinophilic gastroenteritis[J]. Medicine (Baltimore), 1970, 49(4): 299-319.
doi: 10.1097/00005792-197007000-00003 URL |
[3] |
Talley NJ, Shorter RG, Phillips SF, et al. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues[J]. Gut, 1990, 31(1): 54-58.
doi: 10.1136/gut.31.1.54 pmid: 2318432 |
[4] | 邓艳伟, 白朝霞, 李威. 嗜酸性粒细胞胃肠炎的多排螺旋CT诊断价值[J]. 医学影像学杂志, 2017, 27(8): 1498-1500. |
[5] | 李兵, 伍洋, 王杰春, 等. 64排CT小肠造影在肠道炎性病变诊断的临床应用[J]. 影像研究与医学应用. 2019, 3(19): 54-56. |
[6] |
Ashitani K, Tsuzuki Y, Yamaoka M, et al. Endoscopic features and diagnostic procedures of eosinophilic gastroenteritis[J]. Intern Med, 2019, 58(15): 2167-2171.
doi: 10.2169/internalmedicine.2298-18 URL |
[7] |
Nguyen N, Kramer RE, Friedlander JA. Videocapsule endoscopy identifies small bowel lesions in patients with eosinophilic enteritis[J]. Clin Gastroenterol Hepatol, 2018, 16(6): e64-e65.
doi: 10.1016/j.cgh.2017.08.043 URL |
[8] | Mizuo A, Kondo S, Kobara H, et al. Appearance of gastric polypoid lesions in eosinophilic gastroenteritis[J]. J Pediatr Gastroenterol Nutr, 2020, 70(4): e84. |
[9] |
Jensen ET, Martin CF, Kappelman MD, et al. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a national administrative database[J]. J Pediatr Gastroenterol Nutr, 2016, 62(1): 36-42.
doi: 10.1097/MPG.0000000000000865 URL |
[10] |
Ishihara S, Kinoshita Y, Schoepfer A. Eosinophilic esophagitis, eosinophilic gastroenteritis, and eosinophilic colitis: common mechanisms and differences between East and West[J]. Inflamm Intest Dis, 2016, 1(2): 63-69.
doi: 10.1159/000445131 pmid: 29922659 |
[11] |
Kinoshita Y, Furuta K, Ishimaura N, et al. Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis[J]. J Gastroenterol, 2013, 48(3): 333-339.
doi: 10.1007/s00535-012-0640-x pmid: 22847555 |
[12] | Wechsler JB, Hirano I, 柏小寅. 嗜酸性粒细胞性胃肠炎的生物治疗[J]. 中华临床免疫和变态反应杂志, 2018, 12(4): 437-444. |
[13] |
Chang JY, Choung RS, Lee RM, et al. A shift in the clinical spectrum of eosinophilic gastroenteritis toward the mucosal disease type[J]. Clin Gastroenterol Hepatol, 2010, 8(8): 669-675
doi: 10.1016/j.cgh.2010.04.022 URL |
[14] |
Chu VT, Beller A, Rausch S, et al. Eosinophils promote generation and maintenance of immunoglobulin-A-expressing plasma cells and contribute to gut immune homeostasis[J]. Immunity, 2014, 40(4): 582-593.
doi: 10.1016/j.immuni.2014.02.014 pmid: 24745334 |
[15] | Zhang M, Li Y. Eosinophilic gastroenteritis: a state-of-the-art review[J]. J Gastroenterol Hepatol, 2017, 32(1): 64-72. |
[16] |
MacCarty RL, Talley NJ. Barium studies in diffuse eosinophilic gastroenteritis[J]. Gastrointest Radiol, 1990, 15(3): 183-187.
pmid: 2340989 |
[17] |
Han SG, Chen Y, Qian ZH, et al. Eosinophilic gastroenteritis associated with eosinophilic cystitis: computed tomography and magnetic resonance imaging findings[J]. World J Gastroenterol, 2015, 21(10): 3139-3145.
doi: 10.3748/wjg.v21.i10.3139 URL |
[18] |
Kiss Z, Tél B, Farkas N, Garami A, et al. Eosinophil counts in the small intestine and colon of children without apparent gastrointestinal disease[J]. J Pediatr Gastroenterol Nutr, 2018, 67(1): 6-12.
doi: 10.1097/MPG.0000000000001904 URL |
[19] |
Silva J, Canāo P, Espinheira MC, et al. Eosinophils in the gastrointestinal tract: how much is normal?[J]. Virchows Arch, 2018, 473(3): 313-320.
doi: 10.1007/s00428-018-2405-2 |
[20] | 温小恒, 佟建丽, 孙钢, 等. 嗜酸细胞性胃肠炎的临床诊治[J]. 胃肠病学和肝病学杂志, 2014, 23(8): 882-884. |
[21] |
Pineton de Chambrun G, Gonzalez F, Canva JY, et al. Natural history of eosinophilic gastroenteritis[J]. Clin Gastroenterol Hepatol, 2011, 9(11): 950-956.
doi: 10.1016/j.cgh.2011.07.017 URL |
[22] |
Jiménez-Saiz R, Anipindi VC, Galipeau H, et al. Microbial regulation of enteric eosinophils and its impact on tissue remodeling and Th2 immunity[J]. Front Immunol, 2020, 11: 155.
doi: 10.3389/fimmu.2020.00155 pmid: 32117293 |
[23] |
Furuta GT, Fillon SA, Williamson KM, et al. Mucosal microbiota associated with eosinophilic esophagitis and eosinophilic gastritis[J]. J Pediatr Gastroenterol Nutr, 2023, 76(3): 347-354.
doi: 10.1097/MPG.0000000000003685 URL |
[24] |
Ko HM, Morotti RA, Yershov O, et al. Eosinophilic gastritis in children: clinicopathological correlation, disease course, and response to therapy[J]. Am J Gastroenterol, 2014, 109(8): 1277-1285.
doi: 10.1038/ajg.2014.166 pmid: 24957155 |
[25] |
Egan M, Furuta GT. Eosinophilic gastrointestinal diseases beyond eosinophilic esophagitis[J]. Ann Allergy Asthma Immunol, 2018, 121(2): 162-167.
doi: 10.1016/j.anai.2018.06.013 URL |
[26] | 许会丽, 张连峰, 周琳. 嗜酸性粒细胞性胃肠炎98例临床特点与诊治[J]. 世界华人消化杂志, 2017, 25(36): 3224-3229. |
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