儿童紫癜性肾炎的危险因素研究

Study of risk factors in renal involvement in children Henoch-Schonlein purpura

目的分析儿童过敏性紫癜(HSP)的肾脏受累因素。方法将2007年1月1日～12月31日入住安徽医科大学第一附属医院的212例HSP患儿,分为紫癜性肾炎(HSPN)组和非肾炎组,对性别、年龄、临床表现及实验室检验等因素进行单变量和多变量分析。结果①HSP中96例(45.28%)出现肾脏损害,92.71%HSPN患儿尿检异常发生在起病3个月内;②皮疹症状严重,皮疹3月内反复≥3次,持续性剧烈腹痛及关节受累严重与HSPN发生密切相关,Logistic回归分析具有统计学意义(P<0.05)。结论HSP中皮疹、关节、胃肠道等肾外症状严重及皮疹短期内反复多次者,易出现肾脏受累,应严密监测并采取积极治疗措施以防止肾损害的发生和进展。

Objective To analyze children Henoch-Schonlein purpura of nephral involvement factors. Methods 212 cases of children hospitalized with HSP from Jan 1, 2007 to Dec 31, 2007, were divided into purpura nephritis （HSPN） and non-nephritis groups. Such factors as gender, age, clinical and laboratory tests were dealt with by single-and muhi-variable analysis. Results （1）96 cases （45.28%） in HSP were with kidney damage, 92.71% HSPN children with abnormal urine test within 3 months. （2）Symptoms of severe rash, skin rash repeated in three months 93 times, persistent severe abdominal pain and severe joint involvement were closely related to the occurrence of HSPN. Logistic regression analysis had statistical significance （P〈 0.05）. Conclusions In HSP severe rash, joint, gastrointestinal symptoms and skin rash repeated many times in a short period, with kidney easily involved. They should be closely monitored in terms of treatment and positive measures taken to prevent the occurrence of kidney damage and progress.