108例过敏性紫癜性肾损害患儿的诊治体会

目的：总结过敏性紫癜肾损害患儿的诊治体会，提高过敏性紫癜患儿肾损害的诊治效果。方法：对宁夏医科大学第一附属医院儿科2007年1月到2009年12月的108例过敏性紫癜肾损害患儿的临床资料进行回顾性分析。结果：肾损害伴皮肤紫癜100例，占92．6％；治疗过程中皮疹反复出现的56例占51.8％；肾脏表现中单纯性血尿26例占24．1％，单纯性蛋白尿14例占13％，血尿和蛋白尿都有的29例占26．8％，肾病综合征45例占41．7％。白细胞升高70例，血小板升高63例。ESR升高100例，CRP升高54例。血清IgA升高60例，C3升高54例，C4升高8例。行抗链球菌溶血素O（ASO）测定，其中20例升高。本组治愈好转的95倒占87．9％，未愈出院10例占9．2％，复发3例占2．8％。结论：过敏性紫癜肾损害是过敏性紫癜的严重并发症，早期诊断和治疗，根据受累严重程度给予积极个体化治疗，大多患儿预后比较好。

Objective： To summarize the experiences of diagnosis and treatment in the Hench schonlein purpura children kidney damage, for increasing diagnostical level and therapecutical results of the Hench--schonlein purpura children kidney damage. Methods： The clinical data of 108 patients with kidney damage which are from Ning--xia Medical University in January 2007 to December 2009 were analysed retrospec tive----ly. Results： kidney damage associated with skin purpura is 100 cases,92. 6% the cases of recurrent rash is 56（51.8%） The clinical manifestations of the kidney： the cases of idiopathic hematuria is 26（24.1%） ,the cases of idiopathic hematuria is 14（13%）, The case have both of them is 29（26. 8%） nephrotic syn- drome have 45 cases（41. 7%）. Cases of elevated WBC is 70,Cases of elevated platelet is 63. Elevated ESR is 100~ CRP is 54. 60 cases of elevated serum IgA,C3 have 54 cases,CA have 8 cases. Resistance to trepto--coccus hemolysin O （ASO） detection：20 cases are rising. 95 cases of patients is cured or improved（87. 9%）, 10 cases of patients is not cured（9.2%） ,the relapse cases is 3（2. 8Y0）. Conclusion： Kidney damage is severe complications of the Hench--schonlein purpura , early diagnosis and treatment, We offer individualized treatment according to the degree of disease. Most children have a better prognosis.