儿童过敏性紫癜合并肺炎支原体感染的回顾性临床分析

Clinical analysis of Henoch-Schonlein syndrome with Mycoplasma pneumoniae infection in children

目的探讨儿童过敏性紫癜(HSP)与肺炎支原体(MP)感染的相关性,并分析其临床特征、治疗及转归,提高临床医师对HSP与MP的认识。方法对住院确诊为HSP合并MP感染的患儿39例进行回顾性分析,对其临床特征、治疗及转归进行分析总结。结果共确诊的HSP患者202例,其中39例HSP合并MP感染,其男女比例为25∶14,发病年龄为2～13岁。全部患者表现为典型的双下肢对称性紫癜样皮疹,其中腹型HSP为24例,关节型HSP为7例,肾型为4例,腹型合并关节型HSP为3例,腹型合并肾型为1例。近期1个月内有明确上呼吸道及下呼吸道感染表现的为23例,有明确过敏史者7例。所有患者常规给予抗过敏、改善血管通透性及对症治疗等基础上给予阿奇霉素正规治疗,26例患者给予小剂量地塞米松抗感染治疗,3例患者行大剂量甲基强的松龙冲击及丙种球蛋白(IVIG)治疗,治愈36例,好转3例。结论 MP感染可能是HSP的发病因素之一,其临床特点是除典型紫癜外,可伴或不伴有呼吸道感染,给予规则、足疗程的抗MP感染治疗对缩短HSP病程、预防复发尤为重要,大多预后良好。

Objective To analyze the association between Henoch - Schonlein syndrome （HSP） and Mycoplasma pneumoniae （MP） infection in children. Methods Retrospective reviewed analysis of HSP with MP was performed based on the inpatient records of all patients hospitalized in Guangzhou First Municipal People＇s Hospital between 1999 and 2009. Results There were 202 patients diagnosed with HSP and 39 （39/202） eases with MP infection aged from 2 to 12, among whom there were 25 boys and 14 girls. All of the patients presented typical purpura, while abdominal pain, arthralgia and renal impairment were presented in 28, 10 and 5 cases, respectively. Routine management for HSP and MP infection therapy were given, and 36 patients had full recovery and 3 showed improvement. Conclusion MP infection can induce HSP and affect prognosis. Respiratory tract symptoms are not necessarily present in these eases. Regular anti - MP therapy is important in the treatment of HSP with MP infection.