抗链球菌溶血素O阳性为小儿过敏性紫癜复发的危险因素

Positive antistreptolysin O is a risk factor of recurrence in children with allergic purpura

目的明确抗链球菌溶血素O阳性是否为小儿过敏性紫癜复发率的危险因素,以期为预防其复发提供临床指导依据。方法选择2014年1月—2015年12月绵阳市中医医院收治的过敏性紫癜患儿136例,回顾性分析其临床资料,根据患儿出院后12个月内是否复发,将患儿分为复发组(n=48)和未复发组(n=88),统计两组患儿入院时抗链球菌溶血素O的阳性率,采用多因素logistics回归分析探讨过敏性紫癜患儿复发的危险因素。结果复发组患儿抗链球菌溶血素O的阳性率显著高于未复发组,差异有统计学意义(66.67%vs 32.95%,P=0.000)。多因素logistics回归分析显示消化道出血、关节炎和抗链球菌溶血素O阳性均为过敏性紫癜患儿复发的危险因素(P<0.05)。对于抗链球菌溶血素O阳性的患儿,未接受抗链球菌治疗者的复发率显著高于接受抗链球菌治疗的患儿(44.00%vs 23.26%,P=0.036)。结论抗链球菌溶血素O阳性为过敏性紫癜患儿复发的危险因素,通过加强对抗链球菌溶血素O阳性患儿的抗链球菌治疗可降低其复发率。

Objective To analyze whether positive antistreptolysin O is the risk factor for the recurrence of allergic purpura in children. Methods A total of 136 children with allergic purpura in our hospital from January 2014 to December 2015 were selected, and the clinical data were analyzed retrospectively. According to the recurrence within 12 months after discharge from the hospital, the children were assigned into the recurrence group（n = 44） or the non-recurrence group（n = 88）. The positive rate of antistreptolysin O between the recurrence group and the non-recurrence group were compared and the risk factors of recurrence in children with allergic purpura were analyzed. Results The positive rate of antistreptolysin O of the recurrence group was significantly higher than that of the non-recurrence group, and the difference was statistically significant.（66.67% vs 32.95%, P = 0.000）. Logistics regression analysis showed that the digestive tract hemorrhage, arthritis and positive antistreptolysin O were risk factors for recurrence in children with allergic purpura（P 〈 0.05）. For children with positive antistreptolysin O, those who did not receive the antistreptococcal treatment got a higher recurrence rate than those received antistreptococcal treatment（44% vs 23.26%, P = 0.036）. Conclusion Positive antistreptolysin O is a risk factors for recurrence in children with allergic purpura. By strengthening antistreptococcal treatment against streptococcus hemolysin O positive children, the recurrence rate is expected to be reduced.