CAJ | 학술논문

目的：总结国内报道的81例 Kimura 病的临床资料，探讨 Kimura 病的流行病学及病理特点、临床表现、诊断与鉴别诊断和治疗及预后。方法报告本院2014年收治的1例 Kimura 病，同时检索2000年1月至2014年12月中文生物医学文献数据库、万方、中国知网、维普数据库；检索关键词为 Kimura、木村病、嗜酸性淋巴肉芽肿。结果资料完整者81例 Kimura 病，加上本例共82例，其中男63例，女19例，男女比例为3.3∶1，平均年龄39岁，平均病程5.79年。78.05%的病例表现为头颈部皮下肿物，41.46%同时伴有淋巴结病，单纯淋巴结肿大者21.95%，21.95%累及唾液腺，40.24%伴有肿物局部症状，35.37%伴有相关并发症，伴有外周血嗜酸性粒细胞计数增高占85.37%，合并同时血清 IgE 升高占42.68%。28.05%的病例单纯手术治疗，18.29%单纯激素治疗，45.12%采取联合治疗。结论 Kimura 病是一种罕见的、慢性的、不明原因的、炎症性皮下软组织疾病，多见于亚洲青中年男性，常表现于头颈部皮下肿块，伴有局部淋巴结病和部分累及唾液腺，患者外周血及组织中嗜酸性粒细胞增多、血清 IgE 水平增高。手术、局部放射和类固醇激素治疗效果良好，但易复发。
목적：총결국내보도적81례 Kimura 병적림상자료，탐토 Kimura 병적류행병학급병리특점、림상표현、진단여감별진단화치료급예후。방법보고본원2014년수치적1례 Kimura 병，동시검색2000년1월지2014년12월중문생물의학문헌수거고、만방、중국지망、유보수거고；검색관건사위 Kimura、목촌병、기산성림파육아종。결과자료완정자81례 Kimura 병，가상본례공82례，기중남63례，녀19례，남녀비례위3.3∶1，평균년령39세，평균병정5.79년。78.05%적병례표현위두경부피하종물，41.46%동시반유림파결병，단순림파결종대자21.95%，21.95%루급타액선，40.24%반유종물국부증상，35.37%반유상관병발증，반유외주혈기산성립세포계수증고점85.37%，합병동시혈청 IgE 승고점42.68%。28.05%적병례단순수술치료，18.29%단순격소치료，45.12%채취연합치료。결론 Kimura 병시일충한견적、만성적、불명원인적、염증성피하연조직질병，다견우아주청중년남성，상표현우두경부피하종괴，반유국부림파결병화부분루급타액선，환자외주혈급조직중기산성립세포증다、혈청 IgE 수평증고。수술、국부방사화류고순격소치료효과량호，단역복발。
Objective To explore the epidemiological and pathological characteristics, clinical manifestations, diagnosis and differential diagnosis, clinical treatment and prognosis of Kimura disease by summarizing clinical data of 81 patients with Kimura disease.Methods One case admitted in our department in 2014 was reported. Chinese biological and medical literature databases such as Wanfang, China National Knowledge Infrastructure ( CNKI ) and Vip from January 2000 to December 2014 were searched. Key words were Kimura, Kimura’s disease and eosinophilic lymphoid granuloma.Results There were 82 cases ( 63 males and 19 females ) with complete clinical data ( including 1 case in our hospital ). The male female ratio was 3.3:1. The mean age was 39 years, and mean disease course 5.79 years. 78.05% of cases presented with the head and neck subcutaneous mass, and 41.46% were accompanied by regional lymphadenopathy. Simple lymph node enlargement occurred in 21.95% of cases, salivary gland involvement in 21.95%, local symptoms of mass in 40.24%, and related complications in 35.37%. Peripheral blood eosinophilia and elevated serum immunoglobulin E ( IgE ) were found in 85.37% and 42.68% of cases respectively. 28.05% and 18.29% of cases were treated with surgical operation and steroid hormones respectively and 45.12% with combined therapy.Conclusions Kimura disease is a rare chronic inlfammatory disorder of unknown etiology, and usually presents as a subcutaneous mass in the head and neck region or the major salivary glands of young to middle-aged Asian men. It is often associated with regional lymphadenopathy. Elevated serum IgE and peripheral blood eosinophilia are also common. Though surgical resection, regional or systemic steroid therapy and local radiation have good effects, recurrence may occur.