92例过敏性紫癜患儿的临床特征及合并肾损害的危险因素分析

Analysis of clinical features and risk factors of renal injury in 92 children with Henoch Schonlein purpura

目的:探讨92例过敏性紫癜(HSP)患儿的临床特征及其与肾损害的相关性分析。方法:回顾性分析2014年8月至2016年8月兰州大学第一医院收治的92例HSP患儿的临床资料,依据尿常规检查结果,分为肾损害组与非肾损害组,分析发生肾损害的危险因素。结果:儿童HSP好发于7~14岁,占57.61%。男性患儿与女性患儿的比例为1.36∶1。HSP好发于冬、春两季。HSP患儿均伴有皮肤紫癜,以双下肢紫癜明显;有51.09%患儿伴有消化道症状,主要以腹痛、腹胀、呕吐为主;45.65%患儿伴有关节痛。92例HSP患儿中有35例合并肾损害,占38.04%。单因素及多因素Logistic回归分析显示,年龄≥7岁、皮疹反复发作、血浆纤维素蛋白酶原(FIB)增高、血小板计数(PLT)和高密度脂蛋白(HDL)水平降低均为儿童HSP合并肾损害的独立危险因素(P<0.05)。结论:HSP为儿童常见病,具有典型症状;年龄≥7岁、皮疹反复发作、低PLT、低HDL及高FIB为HSP患儿发生肾损害的独立危险因素。

Objective:To investigate the clinical features and related factors of renal injury in 92 children with Henoch Schonlein purpura(HSP).Methods:Clinical data of 92 children with HSP in our hospital from August 2014 to August 2016 were retrospective analyzed.The clinical characteristics and risk factors for renal injury were analyzed.Results:HSP often occurred in 7-14 years old children,accounting for 57.61%.The male and female ratio in the patients was 1.36∶1.HSP often occurred in spring and winter.Children with HSP were accompanied by skin purpura that was obvious in both lower extremities.51.09%of HSP children were accompanied by gastrointestinal symptoms,mainly abdominal pain,abdominal distension and vomiting,and 45.65%children were arthralgia.Of 92 HSP children,there were 35 cases combined with renal damage,accounted for 38.04%.Univariate and multivariate logistic regression analysis revealed that age≥7 years,recurrent rash,increased plasma fibrinogen(FIB)level,decreased platelet(PLT)count and high-density lipoprotein(HDL)level were independent risk factors for renal injury in HSP children(P<0.05).Conclusion:HSP is a common disease in children that is characterized by typical symptoms.Older than 7 years,recurrent rash,increased plasma FIB,and decreased PLT and HDL are independent risk factors for renal injury in HSP children.