Katzka

不过由于此类手术有造成穿孔的风险,因此该指南建议医生采取较为保守和谨慎的治疗方法

在该指南中,作者建议开展识别eoe亚组患者的研究,并进一步探讨该病的遗传学基础以及研究过敏试验的诊断价值此外,作者建议基础学科、胃肠病学及过敏和免疫学方面的专家共同研究该病的自然病程、病理生理、生物标志物、诊断和治疗方法,在增加对该病认识的同时改善该病儿童和成人患者的生活质量(生物谷bioon.com)

eosinophilic esophagitis: updated consensus recommendations for children and adults

《过敏与临床免疫学杂志》(journal of alle食管炎有偏方吗rgy and clinical immunology)7月刊上发表的新版嗜酸粒细胞性食管炎(eoe)临床指南将该病定性为一种免疫和抗原介导的慢性疾病,并指出其在成人和儿童中的发病率趋于增加,但确切原因不明此外,近年来还观察到该病儿童患者的病情趋于严重该指南首次指出,该病可能存在遗传基础(5号染色体异常)除了遗传易感性之外,食物过敏增加可能也是eoe发病率增加的根源(j. allergy clin. immunol. july 2011;128:3-20.e6)

2011-7-11 10:28:33

作者:elsevier

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关键词:嗜酸粒细胞性食管炎

该指南综合了来自33位儿科和成人胃肠病学、免疫学和过敏学专家的诊断、治疗及研究建议

宾夕法尼亚大学儿科教授兼费城儿食管炎饮食注意童医院儿童嗜酸粒细胞性疾病中心主任chris a. liacouras博士是该指南的第一作者,其指出,目前人们的食物与上世纪五六十年代基本相同,不同之处可能在于食物加工方式不一样,不过这还有待于研究证实

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在治疗方面,儿童患者通过避免食用常见的致敏食物可逆转损伤而成人患者的eoe病程一般持续终身,只能通过对症治疗加以控制对于成人和儿童患者,通常可应用局部类固醇进行治疗,例如配合储雾罐吞入(而非吸入)氟替卡松,也可服用布地奈德口服糖浆英夫利昔单抗等生物制剂可能对该病无效对于一些食管狭窄程度高的患者,可进行食管扩张术

eosinophilic es食管炎的中药偏方ophagitis (eoe) is a clinicopathologic condition of increasing recognition and prevalence. in 2007, a consensus recommendation provided clinical and histopathologic guidance for the diagnosis and treatment of eoe; however, only a minority of physicians use the 2007 guidelines, which require fulfillment of bot食管炎的偏方h histologic and clinical features. since 2007, the number of eoe publications has doubled, providing new disease insight. accordingly, a panel of 33 physicians with expertise in pediatric and adult allergy/immunology, gastroenterology, and pathology conducted a systematic review of the eoe literature (sin食管炎的饮食疗法ce september 2006) using electronic databases. based on the literature review and expertise of the panel, information and recommendations were provided in each of the following areas of eoe: diagnostics, genetics, allergy testing, therapeutics, and disease complications. because accumulating animal and h食管炎的偏方uman data have provided evidence that eoe appears to be an antigen-driven immunologic process that involves multiple pathogenic pathways, a new conceptual definition is proposed highlighting that eoe represents a chronic, immune/antigen-mediated disease characterized clinically by symptoms related t治食管炎偏方o esophageal dysfunction and histologically by eosinophil-predominant inflammation. the diagnostic guidelines continue to define eoe as an isolated chronic disorder of the esophagus diagnosed by the need of both clinical and pathologic features. patients commonly have high rates of concurrent allerg食管炎的症状有哪些ic diatheses, especially food sensitization, compared with the general population. proved therapeutic options include chronic dietary elimination, topical corticosteroids, and esophageal dilation. important additions since 2007 include genetic underpinnings that implicate eoe susceptibility caused by po食管炎可以治好吗lymorphisms in the thymic stromal lymphopoietin protein gene and the description of a new potential disease phenotype, proton pump inhibitor-responsive esophageal eosinophila. further advances and controversies regarding diagnostic methods, surrogate disease markers, allergy testing, and treatment a治疗食管炎的中成药pproaches are discussed.

chris a. liacouras, md, glenn t. furuta, md, ikuo hirano, md, dan atkins, md, stephen e. attwood, md, frcs, frcsi, mch, peter a. bonis, md, a. wesley burks, md, mirna chehade, md, margaret h. collins, md, evan s. dellon, md, mph, ranjan dohil, md, gary w. falk, md, ms, nirmal食管炎饮食调理a gonsalves, md, sandeep k. gupta, md, david a. katzka, md, alfredo j. lucendo, md, phd, jonathan e. markowitz, md, msce, richard j. noel, md, robert d. odze, md, frcp, philip e. putnam, md, faap, joel e. richter, md, facp, macg, yvonne romero, md, eduardo ruchelli, md, hugh a. sampson, md, alain sc慢性食管炎hoepfer, md, nicholas j. shaheen, md, mph, scott h. sicherer, md, stuart spechler, md, jonathan m. spergel, md, phd, alex straumann, md, barry k. wershil, md, marc e. rothenberg, md, phd, seema s. aceves, md, phd

生物谷推荐原文出处:

journal of allergy and clinical immunologydoi:10.1016/j.jaci.2011.02.040

来源:elsevier

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新诊慢性食管炎怎么治疗断标准建议,根据多次活检的组织学结果和临床表现进行确诊除了少数情况之外,认为15个嗜酸粒细胞/高倍视野是诊断eoe的最低阈值该病的其他组织病理学表现包括基底细胞增生、细胞间隙扩大以及固有层纤维化要排除患者是否患eoe,一开始最常使用质子泵抑制剂(ppi)如果ppi治疗有效,则可排除eoe在青少年和成人患者中,早期可出现吞咽困难、反流和烧心,其中吞咽困难是最常见的症状婴儿患者通常存在进食问题,并常伴随食物过敏、哮喘、湿疹、慢性鼻炎和环境过敏等特应性疾病的其他表现斑贴试验是有效的辅助诊断方法,但并非完美,因为eoe不是过敏性事件、迟发型事件或免疫球蛋白介导事件,所以依据过敏试验难以确诊