儿童过敏性紫癜临床分析

Clinical analysis of anaphylactoid purpura in children

目的分析过敏性紫癜多器官损害的临床特点,以减少临床工作中的误诊率。方法对64例确诊的过敏性紫癜患儿的临床资料,包括发病年龄、好发季节、发病诱因、常见病史、首发症状、临床表现、实验室检查进行系统回顾。结果64例过敏性紫癜患儿中4~8岁49例(76.56%),冬春季发病52例(81.25%),呼吸道感染为诱因者42例(65.63%),除基本上均有皮肤紫癜外,腹部症状15例(23.4%),关节肿痛12例(18.8%),肾脏受损6例(9.4%)。结论儿童过敏性紫癜多见于学龄前期及学龄期儿童,以冬春季节发病较多,上呼吸道感染为主要诱发因素,皮肤紫癜为主要临床表现,但以腹痛及关节肿痛为首发症状的不典型病例易导致误诊,因此在临床工作中应加强重视。

Objective To investigate the clinical characteristics of multiple organ damage in children patients with anaphylactoid purpura so as to reduce the misdiagnosis rate in clinical practice.Methods The clinical data about 64 patients with anaphylactoid purpura,including the age of onset,the predilection season of onset,the predisposing factors,the common disease history,the first symptom,the clinical manifestation and the laboratory examination were retrospectively analyzed.Results Of the 64 patients,49 patients(76.56%)were 4~8 years old,52 cases occurred in winter and spring(81.25%),and 42 cases were induced by respiratory tract infection(65.63%).Besides all the patients had purpura on skin,there were 15 cases of abdominal symptoms(23.4%),12 cases of joint swelling pain(18.8%),and 6 cases of kidney damage(9.4%).Conclusion The child anaphylactoid purpura is more common in pre-school age and school age children,which aften occurs in winter and spring,and main inducing factors are upper respiratory tract infection and main clinical manifestations are skin purpura.However the atypical cases with the first symptoms of abdominal pain and joint swelling pain are easy to be misdiagnosed,which should be paid much attention to in clinical practice.