西藏高原地区儿童过敏性紫癜的临床分析

Clinical analysis of childhood Henoch-Schonlein purpura on the Tibetan Plateau, China

摘要:

目的 研究西藏高原地区儿童过敏性紫癜(HSP)的临床特点.方法 以西藏山南地区人民医院收治的125例HSP患儿作为观察组,武汉市儿童医院收治的96例HSP患儿为对照组,对两组儿童HSP的发病特点、临床表现、治疗及预后进行回顾性对比分析.结果 西藏山南地区HSP患儿平均发病年龄高于对照组(P<0.05),女性构成比高于对照组(P<0.05);发病季节与对照组比较差异有统计学意义(P<0.05).观察组发病诱因与对照组比较差异有统计学意义(P<0.05).与对照组相比,观察组消化道症状更明显(P<0.05).观察组白细胞、血小板计数、血沉、中性粒细胞百分比均值低于对照组(P<0.05),血红蛋白含量高于对照组(P<0.05).经治疗后痊愈或好转出院124例(99.2%),治愈及好转率与对照组比较差异无统计学意义(P>0.05).门诊随访发现复发3例(2.4%),低于对照组(16.7%,P<0.05).结论 西藏高原地区儿童HSP患儿在发病特点、临床症状、实验室检查等方面与平原地区相比存在部分差异;总体预后较好,复发率较低.

Abstract:

Objective To study the clinical characteristics of childhood Henoch-Schonlein purpura (HSP) on the Tibetan Plateau, China. Methods One hundred and twenty-five HSP children admitted to Shannan People's Hospital, Tibet, were assigned to the observation group, and 96 HSP children admitted to Wuhan Children's Hospital were assigned to the control group. The disease characteristics, clinical manifestations, treatment, and prognosis in both groups were retrospectively analyzed and compared. Results The mean age of HSP onset and the female-to-male ratio in the observation group were both significantly higher than in the control group (P<0.05). There was a significant difference in seasonal onset between two groups. Significant differences in the etiological factors were observed between the two groups (P<0.05). The gastrointestinal manifestation was more prominent in the observation group compared with that in the control group (P<0.05). Laboratory findings showed that the mean erythrocyte sedimentation rate, counts of white blood cells and platelets, and percentage of neutrophil leucocytes were significantly lower, while the hemoglobin level was significantly higher in the observation group than in the control group (P<0.05). A total of 124 HSP patients (99.2%) in the observation group had a full recovery or improvement, and the overall cure rate and improvement rate showed no significant differences between two groups (P>0.05). Only 2.4% of the patients (3 cases) in the observation group had recurrent attack during follow-up, which was significantly lower than that in the control group (16.7%; P<0.05). Conclusions Childhood HSP on the Tibetan Plateau shows partial differences in disease characteristics, clinical manifestations, and laboratory measurements compared with that in the plain area. The overall prognosis is better and the recurrent rate is lower among HSP children on the Tibetan Plateau.