Clinical Analysis Of Eosinophilia

目的:探讨可引起嗜酸细胞增多的常见疾病.方法:回顾性分析2008年至2009年,北京协和医院1年内外周血嗜酸细胞绝对计数≥0.5×109的住院患者,分析可引起嗜酸细胞增多症的常见疾病及临床特点.结果:2008-5月至2009-5月符合嗜酸细胞增多症的病例共248例,并根据嗜酸细胞绝对计数分为分为轻度.中度.重度升高.在这组疾病中,明确诊断的241例,占97.33％,不明原因7例,占2.7％.明确诊断的疾病包括:反应性的嗜酸细胞增多227例,其中感染性疾病28例,占11.3％,主要为细菌感染.寄生虫感染.真菌感染等；非感染性疾病199例,主要为肿瘤(48例)占19.3％,皮肤科疾病(40例)占16.1％,变态反应性疾病(36例)占14.5％,结缔组织病占(21例)占11.2％,药物因素占(19例)占7.6％,其他原因疾病(35例)占14.4％,主要为外科疾病(胆囊结石.脾切除术后),内分泌疾病,慢性肾功能衰竭.内分泌疾病.嗜酸性肌炎.嗜酸性胃肠炎.嗜酸性肉芽肿等；原发性嗜酸细胞增多症中:特发性嗜酸细胞增多症7例；克隆性嗜酸细胞增多症,即血液系统疾病合并嗜酸细胞增多7例.结论:嗜酸细胞增多症中继发因素较为常见,多为轻度升高,主要为肿瘤(指实体肿瘤如肺癌.胃癌等),其次为皮肤科疾病.变态反应性疾病.结缔组织病及感染.其中淋巴瘤造成的嗜酸细胞增多可以中重度升高,其他造成中重度嗜酸细胞增多的原因多见于特发嗜酸细胞增多症,变应性肉芽肿性血管炎及血液疾病,可以通过骨髓检查.基因学检查.临床症状分析等方法鉴别诊断.Objective:to investigate the causes of eosinophilia；Methods:clinical date were retrospectively analyzed from patients with eosinophilia hospitalized in Peking Union Medical college Hospital；Result:out of the 248cases,definte diagnosis were achieved in 241 patients,reactive disease was the most common causes,infectious disease were accounted for11.2％,patient suffered from noninfectious disease:with cancer,dermatology disease, allergic reactive.connective tissue disease.drug reactive for 19.3％,16.1％,14.5％.11.2％.7.6％of this category respectively.The other disease including endocrine disease,surgical disease,chronic renal failure.Primary(nonreactive)eosinophilia,either'clonal' or'idiopathic' were accounted for 5.6％.Hypereosinophilic syndrome were accounted for 2.8％, clonal eosinophilia were accounts for 2.8%.Conclusions:While noninfectious diseases,especially cancer,were the most common causes., the causes of most eosinophilia cases can be diagnosed eventually after careful analysis of clinical data. obsjective:to investigate the difference between churg strauses' syndrome and idiopathic hypereosinophilic syndrome,lymphoma eosinophilia.methods:clinical date were retrospectively analyzed from patients with lymphoma eosinophilia,churg strauses' syndrome and idiopathic hypereosinophilic syndrome hospitalized in Peking Union Medical college Hospital; result:we compared the idiopathic hypereosinophilic syndrome with churg strauses' syndrome, churg strauses'syndrome has a high positive rate in CRP,ESR, and the involvement of nervous system, heart, blood vessel was different from idiopathic hypereosinophilic syndrome. we compared the idiopathic hypereosinophilic syndrome with eosinophilia in lymphoma, IHES had higher level of LDH, absolute eosinophilic count; The incidence of lymph node enlargement the involved lung were higher in IHES. The involved organs were different form IHES.Conclusions:The involved orangs and the laboratory examination are different in these diseases.