嗜酸性粒细胞性消化道炎

摘要

原发性嗜酸性粒细胞性消化道炎(eosinophilic gastrointestinal disease,EGID)是以消化道嗜酸性粒细胞异常浸润为特征的炎症性疾病.该病可以累及消化道全长或某一部分,包括嗜酸性粒细胞性食管炎(eosinophilic esophagitis,EE)、胃炎、胃肠炎(eosinophilic gastroenteritis,EG)、小肠炎、结肠炎及直肠炎.在过去的几十年中,文献报道的发病率逐渐增高.其病因及发病机制并不清楚,大多数研究结果都提示,吸入和食物过敏反应可能诱发该病的发作.其临床主要表现为各种消化道症状,无特异性,诊断标准未得到一致公认,多强调以病理为主的综合诊断,同时要除外其他继发性消化道嗜酸性粒细胞增多疾病.治疗以控制饮食和糖皮质激素为主,近年出现针对发病机制的生物制剂治疗,但尚缺少充分的循证医学依据.%Primary eosinophilic gastrointestinal disorders are inflammatory disease characterized by the infiltration of gastrointestinal tract with eosinophil in the absence of known causes for eosinophilia such as parasitic infections and so on. The disorders can affect whole or part of the gastrointestinal tract, and include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, eosinophilic colitis and eosinophilic rectitis. In the past decades, the reported prevalence of these disorders is increasing. The etiology and pathogenesis is unclear, and many researches reveal that aeroallergen and food allergen may induce the relapse of these disorders. The clinical presentation can include all kinds of gastrointestinal symptom. Diagnosis of these disorders is dependent on the clinical presentation, endoscopic findings and most importantly, histological confirmation, and excluding the known causes for eosinophilia.Dietary modifications and corticosteroids are first-line treatment. Recent years, there are some biological agents aimed to the pathogenesis, but lack of sufficient support from evidence-based medicine.