成人过敏性紫癜性肾炎合并胃肠道表现的危险因素分析

Risk factors of adult Henoch-Schonlein purpura nephritis with gastrointestinal manifestations

目的研究成人过敏性紫癜性肾炎合并胃肠道表现的危险因素。方法对2004年1月至2009年5月在卫生部中日友好医院住院的118例成人过敏性紫癜性肾炎患者的人口统计学资料、临床表现、实验室检查、病理学结果及转归等指标进行回顾性分析。结果 118例患者中,52例(44.1%)有胃肠道表现,为病例组;其余66例无胃肠道表现,为对照组。病例组与对照组相比,表现出较高的关节受累(P<0.001)、较高的中性粒细胞计数(P<0.05)、较高的血小板计数(P<0.01)、较低的白蛋白水平(P<0.05)、较低的血钠(P<0.05)和较低的免疫球蛋白G水平(P<0.05)。非条件Logistic回归分析显示,关节受累、中性粒细胞计数和免疫球蛋白G水平是3个独立的危险因素,OR值分别为5.010、1.248和0.999。结论关节受累、较高的中性粒细胞计数和较低的IgG水平是成人过敏性紫癜性肾炎合并胃肠道表现的3个独立的危险因素。

Objective To determine the risk factors of Henoch-Schonlein purpura nephritis（HSPN） in adult patients with gastrointestinal manifestations.Methods The demographic,clinical,laboratorial,pathologic features and prognosis of 118 adult HSPN patients who treated in the China-Japan Friendship Hospital,during the period of January 1,2004 to May 31,2009,were analyzed.Results Of the 118 patients,52 cases（44.1%） were positive for gastrointestinal manifestations（case group） and 66 were controls gastrointestinal manifestations（control group）.Compared with the control group,patients in the case group have higher percentage of joint involvement（P0.001）,higher neutrophil count（P0.05）,higher platelet count（P0.01）,lower albumin（P0.05）,lower serum natrium（P0.05） and lower immunoglobulin G（P0.05）.In unconditional Logistic analysis,joint involvement（OR 5.010）,neutrophil count（OR 1.248）,and immunoglobulin G（OR 0.999） showed statistical difference.Conclusion Higher percentage of joint involvement,higher neutrophil count and lower immunoglobulin G are three independent risk factors for HSPN in adult patients with gastrointestinal manifestations.