儿童荨麻疹与成人荨麻疹患者临床特征的比较分析

Clinical characteristics of urticaria in children versus adults

摘要:

目的 探讨儿童荨麻疹和成人荨麻疹临床特征的差异，为儿童荨麻疹的病因、病情评估及治疗提供参考依据。方法 收集2013年1月至2017年5月在中南大学湘雅医院皮肤科就诊的2411例荨麻疹患者资料进行社会人口学特征分析，并对其中获得完整随访资料的740例荨麻疹患者进行儿童（68例）和成人（672例）荨麻疹临床特征的比较分析。结果 儿童组中急性荨麻疹314例，占76.4%（314/411），而成人组以慢性自发性荨麻疹为主（44.8%，896/2 000）。儿童急性荨麻疹以感染为病因者占41%（16/39）。儿童急性荨麻疹的伴随症状以腹痛/腹泻为主（44%，17/39），而成人急性荨麻疹以胸闷/气促为主要伴随症状（32%，11/34）。儿童组慢性荨麻疹治疗前后疾病严重度评分低于成人组（P < 0.05）；儿童组第二代抗组胺药治疗有效率高于成人组（82.1% vs 62.2%，P < 0.05）。儿童组荨麻疹个人史及家族史阳性率均高于成人组（P < 0.05）。结论 儿童荨麻疹中以急性荨麻疹多见，主要伴随症状为腹痛/腹泻，与成人不同。儿童慢性荨麻疹的疗效较成人佳。儿童急性荨麻疹患者常见病因为感染。具有特应性体质儿童可能易患荨麻疹。

Abstract:

Objective To study the clinical characteristics of urticaria in children versus adults, and to provide reference for the etiological analysis, disease evaluation, and treatment of urticaria in children. Methods The clinical data of 2411 patients with urticaria who visited the Department of Dermatology at Xiangya Hospital of Central South University from January 2013 to May 2017 were collected to study their socio-demographic characteristics. The clinical characteristics of urticaria were compared between the 68 children and 672 adults of the 740 patients with complete follow-up data. Results Among the 411 pediatric patients, 314 (76.4%) had acute urticaria; among the 2 000 adult patients, 896 (44.8%) had chronic spontaneous urticaria. The causes of acute urticaria in children included infection (41%, 16/39). The accompanying symptoms of acute urticaria in children mainly included abdominal pain and diarrhea (44%, 17/39), while those in adults mainly included chest distress and shortness of breath (32%, 11/34). Compared with the adult patients, the pediatric patients had signifcantly lower chronic urticaria activity scores before and after treatment (P < 0.05), a signifcantly higher rate of response to second-generation antihistamines (82.1% vs 62.2%; P < 0.05), and a signifcantly higher proportion of individuals with a personal and family history of urticaria (P < 0.05). Conclusions Acute urticaria is more commonly seen than chronic urticaria in children with urticaria, and the main accompanying symptoms are abdominal pain and diarrhea, which are different from adults with urticaria. Chronic urticaria has a better treatment outcome in children than in adults. The most frequently seen cause of acute urticaria is infection in children. Atopic children may be susceptible to urticaria.