儿童腹型过敏性紫癜的误诊原因及治疗研究

The research of misdiagnosis and treatment of abdominal allergic purpura

目的:分析腹型过敏性紫癜(AAP)被误诊的原因及治疗方法,以提高其诊治水平。方法:将68例AAP患儿按是否使用西咪替丁,分为观察组(36例)、治疗组(32例),分析其病因、紫癜特点及被误诊的情况,并比较两组间的疗效。结果:感染尤其是上呼吸道感染是AAP最常见的病因,食物过敏次之;大多数患儿胃肠道症状与皮肤紫癜同时出现;AAP最易被误诊为急性胃肠炎,肠梗阻次之;治疗方面,在静脉使用地塞米松及口服抗过敏药的基础上,加用西咪替丁静脉滴注,可明显缩短患儿的出血时间、胃肠道症状及紫癜消失的时间,P均<0.05。结论:AAP的详细问诊及全面体查是确诊的关键,治疗方面应注意联合用药。

Objective： To advance the ability of diagnosis and treatment of abdominal allergic purpura （AAP）. Methods：68 cases were divided into two groups： observation group （with cimetidine,36 cases） and control group （without cimetidine,32 cases）, and the pathogen, feature of purpura and misdiagnosis of the cases were counted. The curative effect was compared. Results：Infection, especially the upper respiratory tract infection, was the most the most common pathogen for AAP, and the food allergy was the second reason. It was common that the purpura appeared at the same time as gastrointestinal tract symptoms. The AAP was often misdiagnosed as gastro-enteritis, intestinal obstruction the second. About treatment, basing on dexamethasone and cyproheptadine, using cimetidine could bring shorter BT, low positive rate of cuff motion test, shorter recessiontime for symptoms and purpura, indicating that cimetidine made better outcome than that of without ones. Conclusion： Detailed-oriented inquiry and physical examination was vital for accurate diagnosis of AAP, and cimetidine could help steroids promote recovery of abdominal allergic purpura.