临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (10): 741-.doi: 10.3969/j.issn.1000-3606.2017.10.006

• 消化系统疾病专栏 • 上一篇    下一篇

婴幼儿过敏性结肠炎临床特点及其肠黏膜中嗜酸粒细胞 阳离子蛋白的表达#br#

徐俊杰 1, 刘秀美 2, 张利红 2, 魏绪霞 1, 杜庆霞 1   

  1. 山东大学齐鲁儿童医院/济南市儿童医院1.消化科,2.病理科(山东济南 250022)
  • 收稿日期:2017-10-15 出版日期:2017-10-15 发布日期:2017-10-15

Clinical characteristics of allergic colitis and the expression of eosinophil cationic protein in intestinal mucosa in infants 

 XU Junjie1, LIU Xiumei2, ZHANG Lihong2, WEI Xuxia1, DU Qingxia1   

  1. 1.Department of Gastroenterology, 2. Department of Pathology, Qilu Pediatric Hospital of Shandong University, Jinan 250022, Shangdong, China
  • Received:2017-10-15 Online:2017-10-15 Published:2017-10-15

摘要: 目的 研究婴幼儿过敏性结肠炎的临床特征及其肠黏膜组织中嗜酸粒细胞阳离子蛋白(ECP)的表达。方 法 回顾分析2011年9月—2014年2月收治的24例过敏性结肠炎患儿的临床资料;采用免疫组织化学染色法检测和比较 24例过敏性结肠炎患儿肠黏膜及16例幽门螺杆菌感染患儿的胃和十二指肠黏膜组织,以及18例先天性巨结肠患儿肠切 除术后近端正常的肠黏膜中ECP表达的差异。结果 24例过敏性结肠炎中男15例、女8例,婴儿23例,<6月龄20例;临 床表现均有血便,其次为腹泻15例。 1例有湿疹, 3例有药物过敏。内镜下病变主要累及乙状结肠(12例)及直肠(11例), 最常表现为黏膜红斑(21例)、痘疹样结节(18例)、糜烂(3例)及溃疡(3例)等;组织病理学表现为黏膜嗜酸性粒细胞浸润。 过敏性结肠炎患儿肠黏膜ECP阳性嗜酸性粒细胞个数为42(30~60),幽门螺杆菌感染患儿为18(15~23),先天性巨结肠 患儿为25.5(14~35),三组间差异有统计学意义(H=28.14, P<0.001)。 结论 儿童过敏性结肠炎以婴幼儿多见,内镜下 主要表现为黏膜红斑及痘疹样结节。肠黏膜组织中ECP阳性嗜酸性粒细胞数增加是过敏性结肠炎的特征性表现。

Abstract:  Objectives To explore the clinical features of allergic colitis and the expression of eosinophil cationic protein (ECP) in intestinal mucosa in infant and young children. Methods The clinical data of 24 cases of allergic colitis treated from September 2011 to February 2014 were analyzed retrospectively. Immunohistochemical staining was used to detect expressions of ECP in intestinal mucosa in 24 cases of allergic colitis, gastric and duodenal mucosa in 16 cases of helicobacter pylori infection and proximal normal intestinal mucosa in 18 cases of postoperative resection of congenital megacolon, and the results were compared. Results In the 24 subjects (15 males and 8 females) with allergic colitis,. they were infants except for 1 subject, and 20 subjects were <6 months old. All of them had bloody stool, in which there were 15 cases of diarrhea, 1 case of eczema and 3 cases of drug allergy. The endoscopic lesions were mainly showed in the sigmoid colon (12 cases) and the rectum (11 cases). The most common manifestations were mucosal erythema (21 cases), pox like nodules (18 cases), erosions (3 cases), and ulcers (3 cases). Histopathological findings were eosinophilic infiltration of the mucosa. The number of eosinophils in intestinal mucosa was 42 (30~60) in patients with allergic colitis whose ECP was positive, 18 (15~23) in patients with Helicobacter pylori infection and 25.5 (14~35) in patients with congenital megacolon children,  and the differences are statistically significant mong three groups (H=28.14, P<0.001). Conclusions Allergic colitis is more common in infants and young children. The main endoscopic findings are mucosal erythema and eruption like nodules. In addition, the increase of ECP positive eosinophils in intestinal mucosa is the characteristic manifestation of allergic colitis.