儿童过敏性紫癜相关因素调查研究

Investigation and Study on Related Factors of Anaphylactoid Purpura

目的：通过对儿童过敏性紫癜的临床调查研究,以了解与本病相关的年龄、季节、发病、环境、肾脏损害等因素,以期提高对紫癜辨证施治的准确性,提高治疗效果,指导生活预防。方法：对成都中医药大学附属医院儿科门诊及住院病房过敏性紫癜患儿,采用现场调查方式,收集符合纳入标准的病例共150例。对入选的病例,如实填写《过敏性紫癜相关因素调查表》,收集到的资料采用spss 18.0统计软件进行统计学分析,主要采用卡方检验对各组间病例分布进行差异性分析,以P〈0.05为差异显著。结果：（1）本病主要发生在14岁以下儿童,其中7～14岁共计111例,占74%。（2）各发病因素分布比例为：感染（37.3%）、饮食（24.0%）、不明原因发病（16.0%）、药物（13.3%）、运动劳累（9.3%）。（3）复发病例观察：复发次数越多,出现肾脏损害的越多。（4）本研究病例,冬季共57例,春季共41例,合占65.3%,夏季22例,占14.7%。（5）所收集病例,肾脏损害可发生在过敏性紫癜的任何时期,但其高峰在病程〈1个月和病程〉6个月。结论：（1）过敏性紫癜发病,部分患儿在发病前无明显诱因,在可找到的确切诱因中,感染为主要发病因素。空气污染程度、家族饲养动物、家中被动吸烟、家中有霉斑现象、家中有近期装修,对过敏性紫癜的发病具有一定影响作用。（2）儿童过敏性紫癜,复发次数越多,其出现肾脏损害的病例则越多。（3）过敏性紫癜患儿发病年龄主要在7～14岁。（4）过敏性紫癜发病冬季最多,春季次之,夏季最少。（5）过敏性紫癜发生肾脏损害,可发生在病程的任何时期,但最主要发生在疾病初期（〈1个月）和疾病后期（〉6个月）。

Objective：The factors about pediatric allergic purpura（PAP）are analyzed by sorting out and reviewing correlative documents in order to improve the accuracy of diagnosing and treating the disease accordingly and enhance the treatment effect which can guide our everyday life as well. Methods：Aiming at children in the pediatric clinic and pediatric ward of Chengdu university of TCM,the process takes the way of field survey to collect 150 cases according with the inclusion criteria. The inclusion cases should fill the questionnaire for relevant elements and syndromes of HSPN truthfully. Then statistical analysis should be conducted on the collected materials by the spss 18.0 statistical software and Chi-square testing should be mainly used to make divergence analysis about all cases’ distribution,taking P〈0.05 as significant differences. Results：（1）This disease was mainly seen in children under the age of 14 and there was a total of 111 cases within the age range of 7～14 years old,accounting for 74% of total cases.（2）The ratio of each factor in this disease was as follows：infection（37.4%）,diet（24.0%）,unknown（16.0%）,drugs（13.3%）,exercise induced fatigue（9.3%）.（3）Observation of recurrent cases：Kidney functional impairment was worsened with increased recurrence rate.（4）There were a total of 57 winter cases and 41 spring cases in this study,accounting for 65.3% of all cases and 22 summer cases,accounting for 14.7%.（5）Of all the collected cases,kidney impairment could happen at any time during allergic purpura,but it is mostly seen during the 1st month or after the 6th month of this illness. Conclusion：（1）About pathogenesis of HSP,some children never show obvious inducement in the early stage,while among the founded inducements,infection stands as the major. In early HSP cases,chief pathogenesis lies in the unknown origin,while in the relapsing cases,infection and diet. Pathogenesis of HSP,to some extent,may be influenced by air pollution index,domestic animals,second-hand smoking,mildew phenomenon at home and recent decoration.（2）About pathogenesis of HSP,kidney functional impairment was worsened with increased recurrence rate.（3）The pathogenesis of HSP is principally at the age of 7～14.（4）The pathogenesis of HSP appears in the winter and spring in a maximum,while the autumn in a minimum.（5）The renal damage caused by HSP may occur at any time,but primarily in the early stage（〈1 month）and later period（〉6 months）.