过敏性紫癜胃镜特征与临床分析

Endoscopic Characteristics and Clinical Analysis of Henoch-Schonlein Purpura in Children

目的探讨胃镜检查在以腹痛为首发症状的过敏性紫癜(HSP)诊断中的意义。方法对HSP患儿37例通过胃镜检测胃及十二指肠黏膜病变,病变部位取活组织检查,并分析其病变特征与临床的关系。结果病变检出率为62.2%。其中单纯皮肤紫癜检出率为31.3%;伴急性腹痛症状者检出率为100%;单纯关节炎1例和紫癜性肾炎2例均未检出病变。病损以黏膜糜烂、充血、水肿及出血为主要特征。结论HSP患儿胃镜下消化道黏膜病变检出率较高,胃镜检查对儿童HSP,特别是以腹痛为首发症状HSP的早期诊断和鉴别诊断有重要意义。

Objective To investigate the diagnostic significance of endoscopic findings in Henoch- Schonlein purpura（HSP）,especially when abdominal pain preceded the cutaneous lesions. Methods The clinical data and gastroscopic findings in 37 cases of children with HSP were studied and analysed retrospectively in order to detect the pathological changes in the stomach and duodenum mucosa. The biopsy was taken in the pathological changeing place,and the relationship between clinical and endoscopic findings was analyzed. Results Detection rate of the pathological changes in the stomach and duodenum mucosa was 62.2% ,31,3% of which experienced only cutaneous lesions, 100% of which presented the acute abdominal pain. Three patients were not checked up the pathological changes, Of them, 1 had arthritis, 2 had Henoch - Schonlein nephritis. Characteristically endoscopic findings in the stomach and duodenum mucosa were found. The endoscopic findings included anabrosis, hyperemia, edema and hemorrhage, Conclusions Detection rate of the pathological changes in the stomach and duodenum mucosa is higher. Endoscopy is very helpful to the early diagnosis of lISP in children, especially abdominal pain presented firstly.