| 摘要: |
| 目的:总结儿童嗜酸性粒细胞性胃炎(EoG)的临床特点,提高对该病的诊疗水平。方法:回顾性分析2016 年5 月至2024
年8 月于贵阳市妇幼保健院住院的64 例EoG 患儿的临床资料。结果:64 例EoG 患儿中男女比例为0. 88 ∶ 1,EoG 好发于学龄
期及青春期(53. 13%)。腹痛(53. 13%)与呕吐(45. 31%)为主要消化道症状,且发病特征具有年龄异质性,腹痛多见于学龄期
及青春期,呕吐好发于婴儿期(均P<0. 05)。内镜下黏膜充血为最常见表现(98. 44%),有过敏病史患儿内镜下黏膜糜烂的发生
率更高(χ2 =5. 344,P =0. 021)。黏膜组织病理以慢性炎伴大量嗜酸粒细胞(EOS) 浸润为特征,主要累及胃窦(73. 44%)。黏膜
EOS 计数中位数为30(25,40)个/ HPF。按黏膜EOS 计数进一步将患儿分为低浸润组(20~29 个/ HPF)和高浸润组(≥30 个/ HPF)。高
浸润组白蛋白水平低于低浸润组(U =554. 0,P =0. 032);低浸润组腹痛发生率高于高浸润组(χ2 =6. 697,P =0. 010)。98. 44%的
患儿接受抑酸治疗,部分联合饮食回避、孟鲁司特钠及糖皮质激素治疗。结论:儿童EoG 以女性多见,学龄期及青春期高发,不
同年龄段的主要临床表现不同。内镜下以黏膜充血水肿为最常见的表现,组织病理表现以慢性炎症伴大量EOS 浸润为主要特
征,胃窦为主要受累部位。质子泵抑制剂可作为一线治疗选择。 |
| 关键词: 儿童 嗜酸粒细胞性胃炎 临床特征 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.08.010 |
|
| 基金项目:基金项目:贵阳市妇幼保健院公共卫生系列研究,编号(2022)-4-11。 |
|
| Age-Related Clinical Characteristics and Mucosal Eosinophilic Layer Diagnosis and Treatment of EosinophilicGastritis in Children |
| Zhang Jiming1, Sun Yunli2, Zhu Li1,2 |
| (1. Clinical College, Guizhou Medical University, Guiyang 550000, China; 2. Guiyang
Maternal and Child Health Hospital, Guiyang 550000, China)) |
| Abstract: |
| Objective: To summarize the clinical characteristics of children with eosinophilic gastritis (EoG) and improve the level of
diagnosis and management. Methods: Retrospective analysis was conducted on clinical data of 64 children with EoG admitted into
Guiyang Maternal and Child Health Hospital from May 2016 to Aug. 2024. Results: The male-to-female ratio was 0. 88 ∶ 1, with a
predominance in school-age children and adolescents (53. 13%). Abdominal pain (53. 13%) and vomiting (45. 31%) were the main
symptoms, showing age-related differences: abdominal pain was more common in older children, while vomiting predominated in infants
(P<0. 05). Endoscopy most frequently showed mucosal hyperemia (98. 44%), and mucosal erosion was more common in children with
allergic history (χ2 = 5. 344, P = 0. 021). Histopathology revealed chronic inflammation with marked eosinophil (EOS) infiltration,
mainly involving the gastric antrum (73. 44%). The median mucosal EOS count was 30 (25, 40) / HPF. Patients were divided into lowinfiltration
(20 to 29/ HPF) group and high-infiltration (⩾30/ HPF) group. The high-infiltration group had lower albumin levels (U =
554. 0, P =0. 032), while abdominal pain was more frequent in the low-infiltration group (χ2 = 6. 697, P = 0. 010). Most patients
(98. 44%) received acid-suppressive therapy, with some receiving dietary elimination, montelukast, and corticosteroids. Conclusion:
Children with EoG is more common in females and school-age children and adolescents, with age-dependent clinical characteristics.
Under endoscopy, mucosal hyperemia and edema are the most common manifestations, and the histopathological manifestations are
mainly characterized by chronic inflammation with a large amount of eosinophil infiltration, with the antrum of the stomach being the
main affected area. Proton pump inhibitors can be used as the first-line therapy. |
| Key words: children eosinophilic gastritis clinical characteristics |
