以血性腹水为主要表现的过敏性紫癜临床分析

Clinical Analysis of Allergic Purpura with Major Manifestation of Bloody Ascites

目的探讨以血性腹水为主要表现的过敏性紫瘢的临床特征,以进一步提高对该病的认识。方法对我院近年收治的13例以血性腹水、腹痛为主要表现的过敏性紫癜患者的临床资料进行分析,并结合文献进行复习。结果入院时病程2～19d,平均7d,主要表现为腹胀、腹部阵发性剧烈绞痛和腹水。腹水均为血性渗出液,外周血白细胞及中性粒细胞明显增高,92%(12/13)患者的白细胞在15～25×109/L之间。全部患者均为腹型紫瘢合并1至3型其他类型紫瘢。以甲强龙或强的松治疗后均全部治愈,疗程15～35d。结论以血性腹水为主要表现的过敏性紫瘢较为少见,皮肤紫瘢明显延迟出现或不出现者早期诊断有一定困难。治疗主要应用皮质激素,预后良好。

Objective To investigate the clinical features of allergic purpura with major manifestation of bloody ascites in order to enhance the cognition of it. Methods The clinical data of 13 allergic purpura patients with major manifestation of bloody ascites was analysed retrospectively and relevant literatures were reviewed. Results On admission, the course of disease was 2 to 19 days（ average 7 days）. The major manifestations were abdominal distension, severe abdominal colic pain and bloody ascites. The counts of peripheral blood leucocyte and nentrophile granulocyte were very high and the former was 15 - 25 ×10^9/L in 92% （ 12/13 ） of the patients. Each of the patients had other 1 to 3 clinical types of allergic purpura besides abdominal type. All patients were cured with the treatment of urbason or prednisone. The course of treatment was 15 ! 35 days. Conclusion The type of allergic purpura with major manifestation of bloody ascites is rare. Early diagnosis is difficult because of lack of skin purpura, It is treated with corticosteroids and the prognosis is good.