动物蛋白饮食对过敏性紫癜患儿预后的影响分析

Effect of animal protein diet on the prognosis of children with Henoch-Sch?nlein purpura

摘要:

目的 观察动物蛋白饮食与过敏性紫癜（Henoch-Sch?nlein purpura，HSP）复发/皮疹反复的关系，并分析HSP复发的相关危险因素，为临床防治提供依据。 方法 前瞻性选取北京儿童医院2020年10~12月收治的HSP患儿共121例为研究对象，予统一饮食医嘱（无新发皮疹1周后可添加动物蛋白类饮食），门诊随访半年。根据实际有/无摄入动物蛋白饮食，分为观察组（65例）和对照组（56例），记录两组患儿随访期间皮疹反复次数、HSP复发例数及新发肾损害例数；根据病情是否复发，分为复发组（32例）和未复发组（89例），通过食物频率调查问卷记录两组患儿每日动物蛋白摄入量。采用多因素logistic回归分析探讨儿童HSP复发的危险因素。 结果 观察组和对照组的皮疹反复次数、HSP复发率及肾损害发生率比较，差异均无统计学意义（P>0.05）；复发组与未复发组患儿的每日动物蛋白摄入量比较，差异无统计学意义（P>0.05）。多因素logistic回归分析结果显示，初次发病伴肾损害、初次治愈后呼吸道感染、初次治愈后未运动控制均为儿童HSP复发的独立危险因素（P<0.05）。 结论 动物蛋白饮食与HSP复发或皮疹反复无明显相关性。及时治疗肾脏损害、治愈后避免感染、限制剧烈运动，有助于降低儿童HSP的复发率。 引用格式:

Abstract:

Objective To study the association of animal protein diet with the recurrence of Henoch-Sch?nlein purpura (HSP)/skin rash and the risk factors for recurrence of HSP. Methods A prospective analysis was performed for 121 children with HSP who were admitted to the Beijing Children's Hospital from October to December 2020. The children were given the doctor's advice of the same diet (animal protein diet could be added after 1 week without new-onset skin rash). Follow-up was performed at the outpatient service for half a year. According to the presence or absence of animal protein intake, the children were divided into an observation group with 65 children and a control group with 56 children. The times of skin rash recurrence, the incidence of HSP recurrence, and the incidence of kidney injury were compared between the two groups. According to the presence or absence of recurrence, the children were divided into a recurrence group with 32 children and a non-recurrence group with 89 children. A questionnaire on food frequency was used to record the daily intake of animal protein in the two groups. A multivariate logistic regression analysis was used to identify the risk factors for recurrence of HSP in children. Results There was no significant difference between the observation and control groups in the times of skin rash recurrence, the incidence rate of HSP recurrence, and the incidence rate of kidney injury (P>0.05). There was no significant difference in the daily intake of animal protein between the recurrence and non-recurrence groups (P>0.05). The multivariate logistic regression analysis showed that presence of kidney injury at initial onset, respiratory infection after cure for the first time, and lack of exercise control after cure for the first time were independent risk factors for the recurrence of HSP in children (P<0.05). Conclusions There is no significant association between animal protein diet and the recurrence of HSP or skin rash. Timely treatment of kidney injury, avoidance of infection after cure, and limitation of strenuous exercise may help to reduce the recurrence rate of HSP in children. Citation: