小儿HSP合并心电图及心肌酶异常相关因素分析

Related factors of pediatric henoch schonlein purpura combined with electrocardiogram and myocardial enzyme abnormality

目的探讨小儿过敏性紫癜(HSP)合并心电图、心肌酶异常的发生及危险因素。方法选取于2014年8月至2016年7月在四川大学华西第二医院就诊的小儿HSP患儿150例,将合并有心脏损害的患儿归为观察组,共41例,其余109例未合并心脏损害的患儿为对照组。回顾性分析所有患儿的临床资料和实验室资料。统计分析小儿HSP合并心脏损害可能的相关危险因素。结果男性患儿、发病诱因、混合型HSP、低补体血症4种因素可能与HSP患儿合并心脏损害有关,差异均有统计学意义(χ~2值分别为4.338、5.872、4.436、5.756,均P<0.05)。二元Logistic回归分析结果可见,性别(OR=1.919,95%CI:1.262~2.927)、发病诱因(OR=0.451,95%CI:0.279~0.729)、混合型HSP(OR=2.401,95%CI:1.138~5.067)为HSP合并心脏损害的危险因素。结论对于男性HSP患儿、表现为混合型HSP、发病前存在明显诱因的患儿应高度警惕,及时进行心肌酶谱和心电图的检查,对结果异常的患儿应尽早处理,避免出现严重心脏并发症。

Objective To investigate the incidence and risk factors of pediatric henoch schonlein purpura（ HSP） combined with electrocardiogram and myocardial enzyme abnormality. Methods Altogether 150 cases of children with HSP treated in West China Second Hospital of Sichuan University from August 2014 to July 2016 were selected. A total of 41 cases with heart damage were classified as observation group,and the other 109 cases without heart damage were assigned into control group. Clinical data and laboratory data of all children were analyzed retrospectively. Statistical analysis was done to explore the possible risk factors in children with HSP complicated with cardiac damage. Results All four factors including male children,predisposing factors,mixed type of HSP and hypocomplementemia could be associated with cardiac damage in children with HSP,and difference was statistically significant（ χ^2value was 4. 338,5. 872,4. 436 and 5. 756,respectively,all P〈0. 05）. Binary logistic regression analysis showed that gender（ OR = 1. 919,95% CI： 1. 262-2. 927）,predisposing factors（ OR = 0. 451,95% CI： 0. 279-0. 729） and mixed type of HSP（ OR = 2. 401,95% CI： 1. 138-5. 067） were risk factors of HSP combined with heart damage. Conclusion High attention should be paid to male HSP patients of mixed type HSP with obvious predisposing factors before onset. Electrocardiogram and myocardial enzyme tests should be carried out in time. Children with abnormal results should be handled as soon as possible to avoid the occurrence of serious cardiac complications.