基础医学与临床 ›› 2023, Vol. 43 ›› Issue (5): 785-789.doi: 10.16352/j.issn.1001-6325.2023.05.0785

• 临床研究 • 上一篇    下一篇

25例伴外周动脉闭塞的嗜酸性粒细胞增多症患者临床特点分析

韩迎东1#, 王嵩1,2#, 韩欣欣1, 尹月1, 王玉1, 张昀1*, 曾学军1   

  1. 1.中国医学科学院 北京协和医学院 北京协和医院 全科医学科(普通内科),北京 100730;
    2.宿松县中医院 内科, 安徽 安庆 246500
  • 收稿日期:2022-11-02 修回日期:2023-02-20 出版日期:2023-05-05 发布日期:2023-04-26
  • 通讯作者: *zhangyun10806@pumch.cn
  • 作者简介:#对本文有相同贡献
  • 基金资助:
    国家自然科学基金(81901667);北京协和医院中央高水平医院临床科研专项(2022-PUMCH-B-044); 北京协和医学院临床医学专业全科医学人才培养项目(201920200106)

Analysis of clinical characteristics of 25 patients with hypereosinophilia complicated with peripheral arterial occlusion

HAN Yingdong1#, WANG Song1,2#, HAN Xinxin1, YIN Yue1, WANG Yu1, ZHANG Yun1*, ZENG Xuejun1   

  1. 1. Department of General Internal Medicine, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730;
    2. Department of Internal Medicine, Susong County Hospital of Traditional Chinese Medicine,Anqing 246500, China
  • Received:2022-11-02 Revised:2023-02-20 Online:2023-05-05 Published:2023-04-26
  • Contact: *zhangyun10806@pumch.cn

摘要: 目的 提高对以外周动脉闭塞这一少见并发症为主要表现的嗜酸性粒细胞增多症(HE)患者的认识。方法 在北京协和医院2012年4月至2021年10月的555例HE住院患者中,根据纳入排除标准,共筛查出25例HE伴外周动脉闭塞的患者。总结25例患者的首发临床表现、动脉血管闭塞表现及各脏器受累表现,经性别、年龄匹配筛选出同期住院的不伴有外周动脉闭塞的34例HE的患者为对照,比较两组的临床表现及预后差异。结果 患者均为男性,平均为(44.5±16.2)岁。主要病变动脉为上肢尺、桡动脉及下肢胫、腓动脉闭塞,病例组的皮肤和周围神经受累情况显著高于对照组(P<0.05)。实验室检查中,病例组IgA水平高于对照组。病例组中分别有76%和80%的患者接受抗凝治疗或抗血小板治疗,20%接受激素冲击治疗,64%接受免疫抑制治疗,抗凝、抗板、冲击及免疫抑制治疗比例均显著高于对照组(P<0.05)。根据嗜酸性粒细胞水平,两组患者中分别有68%和48%的患者达完全缓解。结论 在伴外周动脉闭塞的HE患者中,皮肤、周围神经系统为最常见受累器官,经过激素及免疫抑制剂治疗后,该组患者整体预后良好。

关键词: 嗜酸性粒细胞增多症, 动脉闭塞, 嗜酸性粒细胞

Abstract: Objective To improve the understanding of hypereosinophilia(HE) rarely complicated with peripheral arterial occlusion. Methods Among 555 inpatients with HE from Peking Union Medical College Hospital from April 2012 to October 2021, 25 cases complicated with peripheral artery occlusion were involved according to the inclusion and exclusion criteria. The initial clinical features, symptoms of arterial occlusion and organ involvement of the 25 patients were summarized. After age and gender matching, 34 HE patients without peripheral artery occlusion as the control group. Clinical manifestations, treatment and prognosis of the two groups were compared. Results All patients were male, with an average of (44.5±16.2) years old. The main involved arteries included ulnar artery, radial artery, tibial artery and peroneal artery. The IgA level and involvement of skin and peripheral nerves in the case group were significantly higher than that in control group(P<0.05). 76% and 80% of the patients in the case group received anticoagulant therapy or antiplatelet therapy, respectively, 20% received steroid pulse therapy and 64% received immunosuppressive therapy, above which were significantly higher than that in control group(P<0.05). As indicated by eosinophil level, 68% and 48% of patients in the two groups achieved complete remission, respectively. Conclusions The skin and peripheral nervous system are the most commonly involved organs in HE patients complicated with peripheral arterial occlusion, and administration of steroids and immunosuppressive medicines may lead to good prognosis.

Key words: hypereosinophilia, arterial occlusion, eosinophils

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