摘要
目的分析婴儿过敏性直肠结肠炎的临床指标。方法回顾性分析郑州大学附属儿童医院2018年1月至2019年12月收治的69例过敏性直肠结肠炎婴儿的临床资料,包括食物不耐受免疫球蛋白G(IgG)、外周血嗜酸性粒细胞水平、平均血小板体积、粪便钙卫蛋白水平、结肠镜下表现、肠黏膜的病理结果以及肠黏膜嗜酸性粒细胞阳离子蛋白表达水平。结果在69例过敏性直肠结肠炎患儿中,男36例,女33例,纯母乳喂养33例,人工喂养10例,混合喂养26例。95.7%的患儿对牛奶不耐受,52.2%的患儿对鸡蛋不耐受。外周血嗜酸性粒细胞计数、平均血小板体积以及粪便钙卫蛋白水平升高的过敏性直肠结肠炎患儿分别有43、39、1例,分别占62.3%、56.5%、1.4%。肠镜下显示疱疹样改变66例(95.7%),糜烂样改变60例(87.0%),少发浅溃疡10例(14.5%),多发浅溃疡2例(2.3%)。病变累及直肠、降结肠及乙状结肠、横结肠的患儿分别占66.7%(46/69)、56.5%(39/69)、37.7%(26/69)。肠黏膜病理显示嗜酸性粒细胞浸润、淋巴细胞聚集、隐窝炎、隐窝脓肿分别有63例(91.3%)、13例(18.8%)、9例(13.0%)、6例(8.7%)。肠黏膜组织中嗜酸性粒细胞阳离子蛋白表达水平升高者占56.5%(39/69)。结论过敏性直肠结肠炎患儿多有腹泻、便血的临床表现,多数患儿对牛奶蛋白过敏,外周血嗜酸性粒细胞水平、平均血小板体积、肠黏膜嗜酸性粒细胞阳离子蛋白表达水平均有不同程度的升高,肠黏膜多为疱疹糜烂样改变。上述指标异常提示患过敏性结直肠炎的可能性大。
Objective To analyze the clinical indexes of infantile allergic proctocolitis.Methods The clinical datas of 69 infants with allergic proctocolitis admitted to Children’s Hospital Affiliated to Zhengzhou University from January 2018 to December 2019 were analyzed retrospectively,including food intolerance immunoglobulin G(IgG),the level of eosinophil in peripheral blood,mean platelet volume,the level of fecal calprotectin,colonoscopic manifestations,pathological results of intestinal mucosa and the expression of eosinophil cationic protein in intestinal mucosa.Results Among 69 infantile allergic proctocolitis,36 cases were male and 33 cases were female.Thirty-three cases were exclusively breastfed,and 10 cases were artificially fed and 26 cases were mixed fed.The children intolerant of milk accounted for 95.7%.The children intolerant of eggs accounted for 52.2%.The children with allergic proctocolitis with increased eosinophil count in peripheral blood,mean platelet volume and fecal calprotectin level were 43 cases,39 cases and 1 case,accounting for 62.3%,56.5%and 1.4%,respectively.There were 66 cases(95.7%)of herpetic change,60 cases(87.0%)of erosive change,10 cases(14.5%)of less shallow ulcer and 2 cases(2.3%)of multiple shallow ulcer under colonoscopy.The lesions were involved with rectum,descending colon with sigmoid colon,and transverse colon,accounting for 66.7%(46/69),56.5%(39/69)and 37.7%(26/69),respectively.The pathological results of intestinal mucosa showed eosinophils infiltration in 63 cases(91.3%),lymphocyte aggregation in 13 cases(18.8%),cryptitis in 9 cases(13.0%)and crypt abscess in 6 cases(8.7%).The children with elevated eosinophil cationic protein expression in intestinal mucosa accounted for 56.5%(39/69).Conclusion Infantile allergic proctocolitis always have diarrhea and hematochezia,mostly allergic to milk protein.The level of eosinophil in peripheral blood,mean platelet volume and the expression of eosinophil cationic protein in intestinal mucosa are increased to varying degrees,and the intestinal mucosa is mostly herpetic and erosive change.The abnormality of the above indicators suggests that allergic proctocolitis is more likely.
作者
权冰洁
QUAN Bingjie(Gastroenterology Department,Children’s Hospital Affiliated to Zhengzhou University/Henan Children’s Hospital/Zhengzhou Children’s Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2021年第18期3302-3304,共3页
Henan Medical Research
