儿童过敏性紫癜伴胰腺损害的临床特征

Clinical characteristics of pancreatic gland damage in children with Henoch-Sch^nlein purpura

目的探讨儿童过敏性紫癜（HSP）所致胰腺损害的临床特征。方法研究对象为2009年8月至2010年6月在湖南省儿童医院肾内科住院诊断为HSP的患儿。全自动生化分析仪检测HSP患儿血、尿淀粉酶，B超观察患儿胰腺形态，观察患儿皮肤、关节、消化道、肾脏损害的临床特征，分析患儿胰腺损害与其他系统损害的关系。结果95例HSP患儿中发生胰腺损害者64例。其中男34例（53．1％），女30例（46．9％），性别比较差异无统计学意义（r=0．56，P〉0．05）。HSP伴消化道损害合并胰腺损害的患儿（53例，82．8％），显著高于HSP不伴消化道损害合并胰腺损害的患儿（11例，17．2％）（，=14．24，P〈0．05）。混合型HSP并胰腺损害者61例（95．3％），亦显著多于HSP仅有皮疹合并胰腺损害（单纯型）者（3例，4．7％）（X2=18．18，P〈0．05）。64例HSP伴胰腺损害的患儿均行胰腺B型超声检查，无一例伴胰腺水肿及结构回声改变。HSP伴胰腺损伤的患儿住院天数为5～39d[（10．80±6．39）d]，不伴胰腺损害患儿住院天数为4～13d[（8．42±3．51）d]，二者住院天数比较差异无统计学意义（t=5．68，P〉0．05）。结论儿童HSP可伴胰腺损害，伴消化道损害及病变累及多系统的患儿更易伴胰腺损害，应引起临床的关注。

Objective To explore the clinical characteristics of pancreatic gland damage in children with Henoch-Schonlein purpura（HSP）. Methods The serum and urine analysis of 95 examples were detected by the automatic biochemical analyzer, which were diagnosed as HSP from Aug. 2009 to Jun. 2010 in Department of Nephrology, Hunan Children＇s Hospital, and the clinical characteristics of them were analyzed. All children were treated with anti-infection and anti-allergic drugs. The pancreatic morphology of patients was observed by B ultrasonic, and the clinical features of skin ,joints, digestive tract, and kidney damage were observed. And the relationship between damage of pancreas and damage of other systems was analyzed. Results There were 64 eases suffering from pancreatic gland damage in 95 HSP children：34 cases were male（53.1% ）,30 cases were female（46.9% ）,and there was no significant difference （X2 = 0.56 ,P 〉 0.05 ）. The incidence of pancreatic gland damage of the patients with allergic purpura combined with abdominalgia was 82.8% （53 cases ） , which was obviously higher than that in the patients without abdominalgia （ 11 cases, 17.2% ）（X2 = 14.24 ,P 〈 0.05 ）. The incidence of pancreatic gland damage in mixed type of allergic purpura（ 61 cases ,95.3% ） was obviously higher than that in the patients which only possess the skin rash（ 3 cases ,4.7% ） （X2 = 18.18 ,P 〈 0.05 ）. The pancreatic glands of the total 64 patients were detected by type B ultrasonic. None of them had been detected with pancreatic gland edema and deformation of structure. The mean hospital stay of the HSP patients with pancreatic gland damage was （10.80 ± 6.39 ） days （5 -39 days ） , while mean hospital stay without pancreatic gland damage was（8.42 ±3.51 ） days （4 -13 days）, and there was no significant difference between them（ t = 5.68, P 〉 0.05 ）. Conclusions HSP children usually were accompanied with pancreatic gland damage, and if they get abdominalgia and multi-system damage they are more likely to be accompanied with pancreatic gland damage, which should be naid attention to.