儿童过敏性紫癜肾损害的相关因素分析

Correlated factors of renal injury in children with Henoch-Schonlein purpura

目的 探讨儿童过敏性紫癜 (Henoch Schonleinpurpura,HSP)继发肾损害的临床相关因素。方法 回顾性分析 2 0 4例HSP患儿 ,对继发及未继发肾损害患儿的临床因素 ,包括性别、年龄、诱因、临床症状、皮疹持续时间和复发情况、外周血白细胞计数等进行比较。结果 ① 2 0 4例HSP患儿合并肾损害者 92例 ,发生率为 4 5 .1% ;继发肾损害以男性患儿居多 (男∶女 =2 .0 7∶1) ,发病年龄平均 9.7± 3.2 8a,明显高于无肾损害组 7.8± 1.4 6a,P <0 .0 1) ;②肾损害组和无肾损害组的感染诱因分别占 6 5 .13%和 4 0 .18% ,皮疹持续时间分别是 12 .4± 3.18d和 8.6± 2 .4 3d ,复发者分别占 5 2 .17%和 16 .0 7% ,外周血白细胞计数分别是 12 .4 6± 4 .32 (× 10 9/L)和 10 .75± 2 .5 4 (× 10 9/L) ,差异均有显著性意义 (P<0 .0 1) ;③单纯皮肤紫癜者、紫癜加关节症状者、紫癜加消化道症状者以及同时有紫癜、关节症状和消化道症状者肾损害的发生率分别是 2 0 .0 % ,4 1.7% ,5 5 .9%和 6 7.5 % ,差异有显著性意义 (P <0 .0 1)。结论 ①HSP患儿中男性 ,和发病年龄大者容易发生肾损害 ;②发病诱因为感染者 ,皮疹持续时间长及皮疹反复者 ,和白细胞计数升高者易发生肾损害 ;③除紫癜外其他伴随症状越多 。

Objective To study the clinical correlated factors of renal injury in children with Henoch Schonlein purpura(HSP).Methods 204 children with HSP were divided into two groups:secondary renal injury and non renal injury group. The gender、age、renal injury elicited factors、rash lasting time、relapse of rash、clinical symtoms、and white blood cell count at the onset of the disease were compared between the two groups. Results ①In all 204 children with HSP, 92 patients suffered from renal injury. ②Comparing with non renal injury group, the ratio of male to female was higher、the mean age of patients was older、 the percentage of the complicated infection was biger、the rash lasting time was longer、the relap rate of rash was higher、and white blood cell count was higher in renal injury group(P<0.01). ③The percentages of renal injury,in the HSP patients with purpura only,with purpura and joint symptoms,with purpura and gastrointestinal tract symtoms,and with all the above symptoms were 20.0%,41.7%,55.9% and 67.5%, respectively(P<0.01). Conclusions ① In HSP children, the elder and male one easy to suffer from renal injury. ② The patients with complicating infection,with long lasting or relapsing rash, or with increasing white blood cell count more easy to suffer from renal injury. ③The more complicating symtoms(especially,the gastrointestinal symptom),the more easy to suffer from renal injury.