儿童过敏性紫癜合并结石症的临床特征分析

Clinical Characteristics of Henoch-schonlein Purpura Complicated with Lithiasis of Children

目的 探讨儿童过敏性紫癜（HSP）合并结石症的临床特征。方法 选取2009年5月—2014年11月首都医科大学附属北京儿童医院收治的HSP患儿3 124例,其中合并结石症31例（0.99%）,包括合并胆石症20例（0.64%）、合并泌尿系结石11例（0.35%）。回顾性分析其临床资料,包括临床表现、实验室检查及治疗转归等。结果31例HSP合并结石症患儿均未见结石梗阻症状,实验室检查14例表现为脂代谢异常,1例血尿酸升高,腹部超声均可见结石。经常规治疗9例患儿住院期间4-18 d结石消失,11例出院后1-5个月内复查结石消失,2例复查结石尚未消失但无不适症状,9例失访。结论 HSP合并结石症临床症状多不典型,很少出现梗阻表现,成因与禁食、入量不足、抗生素类药物的使用及解剖结构异常有关,B超为诊断本病的首选方法。本病多无需特殊治疗,预后良好。

Objective To explore the clinical characteristics of henoch - schonlein purpura （ HSP） complicated with lithiasis of children. Methods A total of 3 124 HSP patients were selected in Beijing Children＇s Hospital, Capital Medical University from May 2009 to November 2014, including 31 （0. 99% ） with lithiasis. Among them , 20 （0. 64% ） were with gallstone 9 11 （0.35%） were with urinarystone. clinical information were retrospectively analyzed, including clinicalmanifestations, laboratory examination and treatment outcome and so on. Results There were no manifestations of obstruction in 31 patients complicated with lithiasis. 14 patients had lipid metabolism abnormality, 1 patient had ur ic acid elevation, and ultrasonic examination showed signs of stones in all the patients. After conventional the rapy, the stones of 9 patients disappeared in 4 - 18 days during the hospitalization period , 11 patiants checked ultrasonic examination again after hospital discharge in 1 to 5 months and found stones had gone, 2 patients rechecked the ultrasonic examination and found stones were still there but with no symptoms, and 9 cases were lost. Conclusion The symptoms of HSP complicated with l ithias is are not very typica l in most cases, and obstruction is rarely appeared. The pathogeny of the disease may involve fast in g, deficiency of liquid , the use of antibiotics and the abnormality of anatomic structural in digestive system and urinary system. Ultrasonic examination is the preferred method to diagnose this disease. No special treatment is needed for this disease in most cases, and most of them have a better prognose.