成人腹型过敏性紫癜的内镜表现

Endoscopic Characteristics of abdominal type Henoch-Schonlein Purpura in adult Patients

目的探讨成人腹型过敏性紫癜的内镜表现,为提高该病确诊率提供依据。方法对31例成人腹型过敏性紫癜的内镜表现进行回顾性分析。结果 31例有不同程度的胃、十二指肠和结肠黏膜受损,表现为胃肠道黏膜弥漫性充血、水肿,广泛多发出血点,红斑、糜烂和溃疡,以十二指肠和回肠末端病变出现率最高,病变最严重。胃肠道黏膜组织病理表现为小血管纤维素坏死、灶性出血,黏膜及黏膜下层可见淋巴细胞和少量中性粒细胞浸润。患者的内镜和临床病理表现的范围和严重程度与消化道症状的程度相一致。结论典型的内镜表现对早期诊断有一定帮助,从而指导正确的治疗。

Objective To investigate the endoscopic characteristics of abdominal type Henoch-Schonlein Purpura（HSP） in adult patients and get better understanding of the disease as the evidences in reaching early diagnosis.Methods Retrospective analysis of endoscopic characteristics in 31 patients diagnosised as HSP,and described the endoscopic features of 31 cases who went gastrocopy and/or colonscopy.Result 31 patients had different lesions in gastric,duodenal or colonic mucosa.Endoscopy demonstrated the damage to the mucose fluctuated from congestive,edema,petechia,widespread hemorrhage spots,erythema to erosive and multiple ulcers.The endoscopy show that the commonest and most serious position involved were the duodenum and the small intestive.Histological manifestations showed massive nuttrephilic infiltration in mucose and submucosa,fibbrotic necrosis of small vessels,focal bleeding,erosis and ulceration.There was prominent accordance in the exents of endoscopic and pathologic manifestation with the severity of gastrointestinal symptoms.Conclusion The typical features of the endoscopic findings are very helpful to the early diagnosis of HSP.Only right diagnosis can be conductive to right treatment.