婴幼儿过敏性胃肠炎临床、消化内镜特点及胃、肠病理改变Study on the Clinical Features of Allergicgastroenteritis,Digestive Endoscope and Pathological Changes in Infants
龙梅,朱莉,罗娜,王潇,潘佩英
LONG Mei,ZHU Li,LUO Na,WANG Xiao,PAN Peiying
摘要(Abstract):
目的:研究婴幼儿过敏性胃肠炎的临床、消化内镜特点以及胃、肠病理改变。方法:36例过敏性胃肠炎婴幼儿,根据患儿临床表现决定是否做消化内镜检查并分为胃镜组、肠镜组及危重组(未做内镜检查),比较3组患儿入院时的血常规、凝血功能、肝功能检查及大便细菌检查结果;总结婴幼儿过敏性胃肠炎的临床表现、消化内镜特点及胃、肠黏膜的病理学改变。结果:36例患儿的临床表现主要为腹泻(52%)、便血(52%)及反复呕吐(47%),肝功能及凝血功能检查均正常,大便细菌培养未见致病菌;胃镜组患儿外周血、活检组织的嗜酸性粒细胞(EOS)较肠镜组升高(P<0.05),消化内镜观察到胃、食道、肠黏膜有不同程度充血、水肿,点、片状红斑和糜烂;胃、食道病理组织检查示9例患儿胃、食道黏膜有EOS浸润,每高倍视野EOS≥20个;肠道组织病理检查示19例患儿肠黏膜有慢性活动性炎症,可见EOS,其中2例患儿每高倍视野EOS>20个。结论:婴幼儿过敏性胃肠炎的临床表现多种多样,消化内镜及胃、肠病理检查具有一定的特点。
Objective: To investigate the clinical features of allergicgastroenteritis,digestive endoscope and pathological changes in infants. Method: Retrospective analysis were carried out in 36 infants diagnosed as allergicgastroenteritis,they were divided into gastroscope group,colonoscopy group and critical group( no endoscopy test) according to receiving digestive endoscopy or not. Comparing blood routine,coagulation function,liver function and fecal bacteria test result; summarizing clinical features of allergicgastroenteritis in infants,digestive endoscopy features,pathological changes in gastric mucosa and intestinal mucosa. Results: Clinical features of 36 infant patients were mainly diarrhea( 52%),hematochezia( 52%) and recurrence of vomiting( 47%); liver function and coagulation function test showed normal result,fecal bacteria cultivation showed no pathogenic bacteria; gastroscope group infant patients showed higher peripheral blood and biopsy eosinophilic granulocyte( EOS)than colonoscopy group( P < 0. 05); comparing results of peripheral blood and EOS of biopsy between colonoscopy group and critical group,coagulation function comparison among three groups of allergic gastroenteritis infant patients,difference showed no statistical difference( P > 0. 05). Digestive endoscopy observed hyperemia and hydroncus of different degrees in gastric,oesophagus intestinal mucosa;dot and flake erythema and erosion were also observed; histopathological analysis of gastric and oesophagus tissues showed that nine infant patients with EOS infiltration in gastric and oesophagus mucosa,HP high power objective ≥20; histopathological analysis of gastric tissues showed chronic active inflammation in intestinal mucosa of 19 infant patients,visible EOS,of which 2 infant patients with HP high power objective > 20. Conclusions: Clinical features of infants allergicgastroenteritis were diversified,digestive endoscopy and gastrointestinal pathology test showed certain clinical features.
关键词(KeyWords):
婴幼儿;过敏反应;胃肠炎;消化内镜;胃镜;肠镜
infant;anaphylaxis;gastroenteritis;digestive endoscoy;gastroscope;colonoscopy
基金项目(Foundation):
作者(Author):
龙梅,朱莉,罗娜,王潇,潘佩英
LONG Mei,ZHU Li,LUO Na,WANG Xiao,PAN Peiying
DOI: 10.19367/j.cnki.1000-2707.2018.08.022
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