40例过敏性紫癜患儿的临床病例分析

Clinical Analysis on 40 Children with HSP

目的:总结儿童过敏性紫癜(HSP)的临床特点、诊断和治疗经验.方法:回顾性分析40例HSP患儿的临床资料,结合文献总结其临床特点、诊断和治疗经验.结果:HSP男女发病率之比为1.5:1,平均年龄8.6岁;发病诱因中感染占40%,接触过敏原占35%;100%的患儿有皮肤紫癜,15%有关节症状,35%有消化道症状,45%有肾脏损害;肾脏损害主要表现为血尿和蛋白尿,在病程后期出现;采用限制活动、清淡饮食、避免再接触过敏原、改善毛细血管通透性、抗过敏等常规治疗方法,有效率为100%,治愈率80%,近期复发率20%.结论:HSP是小儿的常见病.男孩发病略多于女孩.感染、过敏为其主要发病诱因.HSP的主要受累器官为皮肤、关节、胃肠道、肾脏.双下肢的紫癜、腹痛、关节疼痛和血尿等是主要的临床表现,可单独或同时存在.经上述治疗大多数病人治愈,但仍有部分病人复发.

Objective： To summarize the clinical features, diagnostic and curative experience on children＇s HSP. Methods： By retrospectively analysing the clinical materials of 40 children with HSP, and combined with related documents, to summarize the clinical features, diagnostic and curative experiece on HSP. Results： The ratio of incidence for male to that for female was 1.5 ： 1. Average age of children was 8.6 years old; In predisposing factors, infection occupied 40%, being contact with anaphylactogen occupied 35 %. 100 % children have skin purpura. 15 % patients had symptoms of joint. 35 % patients had symptoms of digestive canal. 45 % patients had renal lesions, Renal lesions were mainly manifested with hematuria and proteinuria, which appeared in the later course of disease. By limiting activity, having bland diet, avoiding contact with anaphylactogen, lowering capillary permeability and antianaphylactic treatment, effective rate was 100% and cure rate was 80 %. Recent recurence rate was 20 %. Conclusion： HSP is a kind of commonly encountered disease in children. It more frequently happened to boys than girls. Infection and allergy are the main predisposing factors. HSP mainly affect skin, joint, gastrointestinal tract and kidney, etc. Purpura of lower limbs, abdominal pain, arthralgia and hematuria are main clinical features that exist individually or together. By above-mentioned treatment, morst of patients are cured, but a fraction of patients are prone to recur.