小儿过敏性紫癜128例临床分析

Clinical Analysis on 128 Children with Anaphylactoid Purpura

【目的】探讨小儿过敏性紫癜(HSP)的临床特点、肾损害的相关因素及治疗方法。【方法】对128例HSP患儿的发病特点、临床表现及肾损害的相关因素进行回顾性分析总结。常规治疗(对照组)60例,治疗组68例,在常规治疗的基础上加用西咪替丁治疗,比较二组的疗效。【结果】128例均有皮肤紫癜,88例合并消化道症状(68.7%),78例合并关节症状(61%);肾损害57例(44.5%),其中男性(64.9%)高于女性(35.1%)(P<0.05),紫癜复发者(61.53%)高于初发者(32.89%)(P<0.01);同时发现紫癜合并其他系统症状越多,肾损害发生率越高(P<0.01)。治疗上加用西咪替丁组有效率明显高于对照组(P<0.01)。【结论】HSP发病以学龄前及学龄期儿童、春冬季节发病为多,原因以感染为多见,男性及反复复发者、合并多系统症状者肾损害发生率较高。加用西咪替丁能明显提高疗效且价格便宜,副作用少,值得临床推广。

[Objective]To study the clinical characteristics of anaphylactoid purpura （HSP） in children , the correlated factors of renal damage and its therapy. [Methods] One hundred and twenty eight cases with HSP were retrospectively studied, and the patterns of onset, clinical manifestations and the correlated factors of renal damage were analyzed. They were treated with regular treatment combined with cimitidine, and the effectiveness between two approaches was compared. [Results] All the 128 cases were anaphylactoid purpura. The incidence of renal damage was higher in the male （51.8%） and recurrence patients（61.53%） than that in the female （32.65%） （ P 〈0.05）and patients with first onset（32.89%） （ P 〈0. 01）. The effective rate of regular treatment in combination with cimitidine was more effective than that in control group （ P〈0.01）. [Conclusion] The morbidity of HSP is high in the schoolage and rural children and in the spring and winter seasons. The most important inducing factor is infection. The incidence of renal damage is high in the male and recurrence patients. There are many extrarenal symptoms during early phase in the HSP patients. Those with gastrointestinal symptoms tend to have renal damage. The combination therapy plan is effective for anaphylactoid purpura of children. Moreover it is convenient and cheap with few side effects. Therefore it should be very popular in clinics.