腹型过敏性紫癜的临床特征及内镜下表现

Clinical features and endoscopic performance of abdominal allergic purpura

目的探讨腹型过敏性紫癜的临床和内镜特点。方法回顾性分析2001—2013年收住安徽医科大学第二附属医院消化内科的54例腹型过敏性紫癜患者的临床资料,35例均行胃镜检查,19例行肠镜检查。结果 9例发病前有相应的诱因。54例均以腹痛为首发症状,且症状重、腹部体征轻,皮肤紫癜均在之后出现:18例出现显性消化道出血。内镜检查示胃肠道黏膜充血水肿、淤斑、糜烂、溃疡形成。病变范围广,以十二指肠壶腹降交界及降结肠,乙状结肠为重,激素治疗有效。结论腹型过敏性紫癜临床表现复杂,以症状与体征不符、内镜下胃肠黏膜病变广泛、激素治疗有效为特点,易误诊,需早期行内镜检查协助诊断。

objective To discuss the clinical features and endoscopic performance of abdominal allergic purpura. Methods Clinical data of 54 patients with abdominal allergic purpura was retrospectively analyzed in the Second Affiliated Hos-pital of Anhui Medical University from 2012 to 2013. Thereinto 38 cases examined by gastroscopy,19 cases by enteroscopy. Re-sults Out of the 54 cases,9 cases had precipitating factors. All of the patients performed abdominal pain as initial symptom, and the severity was severe,but the abdominal signs were mild. Skin purpura occurred after abdominal pain,and 18 cases per-formed dominant gastrointestinal hemorrhage. Endoscopic performance included hyperaemia and edema,ecchymosis,erosion and ulceration of gastrointestinal mucous membrane;the extent of disease was wide,mainly in duodenal bulb lower border,de-scending colon and colon sigmoideum. Hormone is effective in the treatment. Conclusion The clinical features of abdominal al-lergic purpura are complex,the characteristics includes conflicting signs and symptoms,wide extent of gastrointestinal mucous membrane and effective hormone treatment. The misdiagnosis rate is high,need early endoscopic examination to make a definite diagnosis.