伴白细胞升高的荨麻疹性血管炎患者36例临床分析

Clinical Analysis of 36 Patients with Urticarial Vasculitis Accompanied with Elevated Peripheral White Blood Cells

目的探讨伴白细胞升高的严重性荨麻疹性血管炎患者临床表现特点。方法回顾性分析本科2017年12月-2019年4月36例严重荨麻疹性血管炎患者临床特点和化验结果。采用Fisher确切概率法(n<40)进行统计学处理。结果女20例,男16例,男女之比约4∶5;平均发病年龄为35岁;外周血WBC≥15.0×10^9/L的患者比WBC<15.0×10^9/L的患者出现发热(60.00%vs.12.50%)、胸闷(70.00%vs.18.78%)、腹痛(80.00%vs.25.00%)、关节痛(65.00%vs.12.50%)、色素沉着(65.00%vs.18.78%)的几率均高,差异有统计学意义(P均<0.01);而外周血WBC≥15.0×10^9/L患者与WBC<15.0×10^9/L患者出现尿检异常和补体降低几率比较差异无统计学意义(P均>0.05)。外周血WBC≥15.0×10^9/L患者中85.00%需使用抗生素治疗。结论白细胞升高达≥15.0×10^9/L患者可能存在未被发现或潜在的感染,往往有更多临床症状并且病情较重。

Objective To investigate clinical features of severe urticarial vasculitis patients with peripheral white blood cells(WBC)elevation.Methods Totally 36 patients with severe urticarial vasculitis and peripheral WBC elevation in our department from December 2017 to April 2019 were retrospectively analyzed.Fisher's exact test(n<40)was used in the statistical method.Results The ratio of male(16 cases)to female(20 cases)was 4∶5;average age was 35 years old.The patients with peripheral WBC≥15.0×10^9/L had fever(60.00%vs.12.50%),chest tightness(70.00%vs.18.78%),abdominal pain(80.00%vs.25.00%),joint pain(65.00%vs.12.50%)and pigmentation(65.00%vs.18.78%)higher than the patients with peripheral WBC<15.0×10^9/L,with statistical significance(P<0.01).There was no significant difference in the incidence of urinary abnormalities and complement reduction between patients with peripheral WBC>15.0×10^9/L and those with peripheral WBC<15.0×10^9/L(P>0.05).85.00%patients(WBC≥15.0×10^9/L)needed antibiotic treatment.Conclusion Patients with peripheral WBC≥15.0×10^9/L may have undetected or potential infections,and are always severe with more clinical symptoms.