儿童过敏性紫癜患者的临床特点分析

Clinical features of heoch-schonlein purpura in children

目的探讨儿童过敏性紫癜(HSP)的临床特点。方法对2003年1月～2009年1月来院诊治的86例过敏性紫癜患儿的发病特点、临床表现进行分析。结果发病年龄均>2岁,平均发病年龄7.9岁;患儿于冬春季节发病占65.12%;有明确诱因、上呼吸道感染为占63.95%。所有患儿均出现皮肤紫癜,分布于下肢(100%)、臀部(47.67%)上肢(16.28%)等。89.53%患儿以皮肤紫癜为首发症状,少数以胃肠道及关节为首发症状后2周内出现皮疹,未见肾脏损害为首发症状者。胃肠道症状发生率(60.47%),关节症状发生率(44.19%),出现肾脏损害发生率(52.33%)。临床上主要表现为血尿和(或)蛋白尿(68.89%)。有43.75%病人血沉增快,20%ASO增高,42.11%病人IgA增高。结论过敏性紫癜好发于学龄期儿童,发病季节为冬春季,发病诱因以感染占首位,临床表现多样,少数患者有复发倾向。

Objective To study the clinical features of heoch-schonlein purpura（HPS） in children.Methods 86 cases with HPS were retrospectively studied.The patterns of onset,clinical manifestations were analyzed.Results The age of onset of all the 86 children with HPS was over two years and the mean age was 7.9 years.Of the 86 children,65.12% developed HSP during the winter and spring months.63.95% of the HSP patients revealed evident predisposing factors,mainly upper respiratory infection.Of all the patients,89.53% had typical purpura as the presenting cutaneous sign.The distribution of rash in the lower extremities,buttock and upper extremities was 100%,47.67% and 16.28%,respectively.Gastrointestinal involvement and arthritis occurred in 60.47% and 44.19%,respectively.Of all the patients,52.33% developed HSP nephritis manifested as isolated hematuria and/or proteinuria（68.89%）.Erythrocyte sedimentation increased in 43.75% of the patients;Antistreptolysin O titers（ASOT） and levels of immunoglobulin A（IgA） increased in 20% and 42.11% of the cases,respectively.Conclusion The morbidity of HSP is high in the shool-age children;HSP attacks mainly in winter and spring.The most important inducing factor was infection;HSP has a variety of clinical manifestations;The majority of patients have favourable prognosis and the minority tend to have a relapse.