儿童过敏性紫癜腹型临床特点及胃镜分析(附450例报告)

The clinical characteristics and gastroendoscopic features of 450 children Henoch-Schonlein purpura patients

目的分析儿童过敏性紫癜腹型的临床和胃镜特点,探讨幽门螺杆菌感染与其关系,为早期诊断提供依据。方法回顾性分析2006年1月至2008年7月因过敏性紫癜腹型住院的450例3～18岁患儿的临床及胃镜检查资料,并进行相关分析。结果临床表现:433例(96.2%)伴有腹痛,以脐周痛为主,167例(37.1%)伴呕吐,97例(21.6%)伴便血,75例(16.7%)伴呕血。胃镜下361例(80.22%)伴十二指肠黏膜改变。幽门螺杆菌感染42例,占9.33%。结论儿童过敏性紫癜腹型临床表现以脐周痛最为多见。胃镜下主要侵犯十二指肠黏膜,胃黏膜次之。本病与幽门螺杆菌感染无明显相关性。胃镜检查是诊断过敏性紫癜腹型的方法之一。

Objective To explore the clinical and gastroscopic characteristics of Henoch-Schonlein purpura （HSP） with abdominal pain in children and Helicobactor pylori infection rate and the relationship with HSP to provide the basis for early diagnosis. Methods 450 cases of children aged 3～18 hospitalized in the ward from January 2006 to July 2008 for HSP with abdominal pain were analyzed retrospectively. Results 96.2% of patients had abdominal pain around navel area, 37.1% had vomiting, 21.6% had bloody stool and 16.7% had hematemesis, 80.22% had duodenal mucosa changes under gastroscope. Forty-two cases （9.33%） had Helicobactor pylori infection. Conclusions Children with HSP with abdominal involvement often have pain around navel area. Under gastroscope, damage of duodenal mucosa is more evident than gastric mucosa. No markerably correlation between HSP with abdominal pain and Helicobactor pylori infection. Gastroscopic examination is one of the method of diagnosing HSP with abdominal pain.