儿童过敏性紫癜325例回顾性分析

Clinical characteristics of Henoch-Schönlein purpura in children

摘要:

目的 了解儿童过敏性紫癜(HSP)的临床特点,以提高对本病的认识,并指导临床诊治。方法 收集2012 年6 月至2014 年6 月诊断为HSP 的325 例住院患儿的临床资料进行回顾性分析。结果 325 例患儿中,春季和冬季发病人数较多,分别占33.8% 和27.4%;感染为诱发HSP 的主要因素(57.2%);紫癜伴发腹部症状和紫癜伴发关节及腹部症状的患儿肾脏损害发生率分别为60.3% 和48.9%,与单纯紫癜患儿相比差异有统计学意义(P<0.05);32 例紫癜性肾炎患儿中,肾脏的病理分级以Ⅲ a 和Ⅲ b 多见,分别占28% 和31%;325 例患儿中260 例(80.0%)D-二聚体增高,218 例患儿中101 例(46.3%)外周血IgA 升高,110 例患儿中62 例(56.4%)CD4⁺ 降低。结论 HSP 发病以冬春季节好发,感染为主要诱因,合并消化道症状者更易发生肾脏损害,肾脏损害的病理分级以Ⅲ a 和Ⅲ b 居多。

Abstract:

Objective To explore the clinical characteristics of Henoch-Schönlein purpura (HSP) in children. Methods The clinical data of 325 hospitalized children who were diagnosed with HSP between June 2012 and June 2014 were analyzed retrospectively. Results In the 325 children with HSP, the incidence of HSP was higher in winter and spring, with 33.9% and 27.4%, respectively. Infection was the major factor to induce HSP (57.2%). The incidence of renal damage in children with purpura accompanied by abdominal symptoms and children with purpura accompanied by abdominal and joint symptoms was 60.3% and 48.9%, respectively, with statistically significant differences compared with children with purpura alone (P<0.05). In 32 children with purpura nephritis, the pathological grades of IIIa and IIIb were more common, accounting for 28% and 31%, respectively. In 325 children, an increased serum D-dimer level was observed in 260 children (80.0%), an increased peripheral IgA content in 101 children (46.3%), and a decreased CD4⁺ cell percentage in 62 children (56.4%). Conclusions A high incidence of HSP is often seen in spring and winter. HSP is often induced by upper respiratory tract infection. Renal damage is more likely to occur in children with digestive tract symptoms, with IIIa and IIIb as the common pathological grades of renal damage.