腹型过敏性紫癜胃镜表现及糖皮质激素疗效观察

Endoscopic features in abdomen type Henoch-Schonlein purpura and effect of corticosteroid

目的为探讨腹型过敏性紫癜（HSP）胃十二指肠黏膜形态改变及糖皮质激素疗效。方法对41例以腹痛为突出症状的HSP患儿进行纤维胃镜检查，并用内窥镜图像处理系统采集图像。41例使用糖皮质激素，治疗1周后观察疗效。结果小儿HSP胃十二指肠病变主要表现为黏膜表面充血，散在分布出血性斑点，伴有水肿、出血糜烂，溃疡，临床腹痛症状越重，黏膜下的出血越显著。糖皮质激素治疗1周腹痛有效率78％，大便潜血转阴率95％。结论纤维胃镜检查对有腹痛型的HSP有诊断意义，糖皮质激素可作为腹痛型HSP首选治疗。

Objective To investigate the morphous change of gastroduodenai mueosa in patients with Henoch-Sehonlein purpura and the effect of corticosteroid. Methods Fiberoptie gastroscope was performed in 41 patients of HSP with abdominal pain as major syndrome. Endoscope image processing system was used to collect images. We gave eortieosteroid in 41 patients for a week and then observed the effect.Results The main gastroduodehal features of pediatric patients of HSP were redness of mueosa surface, diffused distribution of bleeding peteehiae accompanied with edema and erosion, and ulcers. We found that more serious the abdominal pain,more bleeding of submueosa. Effeetive rate of 1 week eortieosteroid for abdominal pain was 78%. Fecal occult blood test turned negative in 95 % patients. Conclusion Fiberoptie gastroseope could be a diagnostic measure of abdomen type HenochSehonlein Purpura. Cortieosteroid could be used as first ehoiee in abdomen type HSP.