西藏拉萨地区过敏性紫癜临床分析

Clinical Characteristics of Henoch-Schnlein Purpura in Lhasa Area of Tibet

目的研究西藏拉萨地区过敏性紫癜（HSP）的发病情况及临床特点。方法对西藏军区总医院在2008年3月—2011年11月收治的HSP病人进行回顾性分析，并与国内外相关研究进行对比分析。结果西藏拉萨地区HSP患者男女比例为2．58：1，发病时间无明显四季差异，年龄4-61岁，平均（20．24-11．0）岁，发病原因以呼吸道感染为主。在临床表现方面，以皮疹发生率最高96．5％，与其他多个报道结论类似，在皮损的严重程度上，明显高于武汉地区；腹部受累比例低于国外报道，高于武汉地区（P〈0．05）；肾脏受累比例与韩国及西班牙报道类似，高于武汉地区（P〈0．05）。本研究中20岁以下发病明显高于20岁以上，发病高峰集中在5-10岁及15-20岁2个年龄段，其中15-20岁年龄段发病人数占20岁以下的41．9％，以入伍新兵为主，且与本研究及其他多个研究15岁以下年龄段相比，累及肾脏的比例也显著升高（P〈0．05）。结论西藏拉萨地区HSP患者在发病原因，发病季节及临床表现等方面有其自身特点，与同纬度的平原地区存在差异。

Objective In order to evaluate the clinical characteristics of Henoch-SchOnlein purpura （HSP） in Lhasa area of Tibet. Methods We retrospectively analyzed the clinical data of HSP patients in the General Hospital of Tibet military region from January 2008 to November 2010. Results The ratio of male to female was 2.58：1. The patients were aged from 4 to 61 （mean age： 20.2 ± 11.0）. And there was no significant seasonal variability of onset time. The incidence of rash was the highest（96.5% ）, which was similar to other reports. But the severity of lesions was worse than Wuhan reports; the incidence of abdominal involvement was lower than the reports from abroad （P〈0.05）, but higher than Wuhan （P=0.012）. The incidence of renal involvement was similar to the Korean and Spain reports, but higher than Wuhan （P〈0.05）. The incidence in children （≤ 20yr） was higher than that in adults （〉20yr）, and the peak age were at range of 5yr to lOyr and 15yr to 20yr. And the 15yr to 20yr group accounted for 41.9% of Oyr to 20yr group. Compared to the group under 15yr in our and other researches, the incidence rate of renal involvement was much higher in 15yr to 20yr group （P〈0.05）. Conclusion There are differences in pathogenesis, onset season and clinical manifestations of HSP in Lhasa compared with other areas.