Objective To investigate the difference among hypereosinophilic syndrome ( HES) , Churg Strauses' syndrome ( CSS) and lymphoma eosinophilia. Methods Clinical date was retrospectively analyzed from patients with hypereosinophilic syndrome, lymphoma eosinophilia, and CCS hospitalized in Peking Union Medical College Hospital. Results Compared with hypereosinophilic syndrome, CSS has higher positive rates in CRP, ESR, and the involvement of nervous system, heart, blood vessel is also different from hypereosinophilic syndrome. These diseases have no difference in terms of eosinophilic count and IgE. CSS with nervous system involvement are more common in peripheral nervous system, HES are more in central nervous system. The clinical manifestation of CSS with vascular involvement is mainly vasculitis, and HES mostly is venous thrombosis. Compared with eosinophilia in lymphoma, HES had higher level of LDH and rnabsolute eosinophilic count. The incidence of lymph node enlargement and lung involvement is higher in HES. The involved organs were different for HES. Conclusions the involved organs and the laboratory examination are different in these diseases.%目的 探讨特发性嗜酸粒细胞增多症(HES)、变应性肉芽肿性血管炎(CSS)、非霍奇金淋巴瘤(NHL)合并嗜酸粒细胞增多在临床表现、实验室检查、脏器受累等方面的异同,为三种疾病的鉴别诊断提供帮助.方法 分析北京协和医院所有明确诊断为淋巴瘤、CSS的住院患者经查询病程存在慢性嗜酸粒细胞持续性升高者及所有明确诊断为HES的住院患者并加以比较,正态分布计量资料比较采用t 检验,计量资料非正态和方差齐性条件,则采用非参数秩和检验,计数资料比较用χ2检验.结果 HES及CSS比较,嗜酸粒细胞绝对计数、IgE升高等均无统计学差异,而神经系统及肺部受累、淋巴结肿大、炎性指标升高等差异有统计学意义(P≤0.05).CSS患者神经系统受累多见于外周神经,而HES多为中枢神经系统.CSS血管受累主要为血管炎,而HES多为动静脉血栓形成.HES与NHL合并嗜酸粒细胞增多比较,嗜酸粒细胞绝对值、淋巴结肿大、肺部受累、LDH升高均有统计学差异(均P≤0.05).嗜酸粒细胞常见的浸润脏器如神经系统、胃肠道等在NHL合并嗜酸粒细胞增多病例中不多见.结论 HES、CSS、NHL合并嗜酸粒细胞增多三类疾病临床特点各有不同,诊断及鉴别需要通过仔细的脏器评估检查、实验室检查及密切的临床随诊.
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