急性荨麻疹住院患者437例回顾性分析

Retrospective Analysis of 437 Inpatients with Acute Urticarial

目的分析急性荨麻疹(acute urticaria,AU)的诱因、临床特征、实验室检查和治疗反应,以及其转归为慢性荨麻疹(chronic urticaria,CU)的可能危险因素。方法回顾性分析2013年1月-2020年5月陆军军医大学西南医院皮肤科诊治的437例AU住院患者的临床资料。结果437例患者平均年龄约(32.54±16.71)岁,男女比例约为1:2.26。288例(65.90%)能够准确告知诱因,203例(46.45%)为感染或感染后用药诱发。437例中220例(50.34%)感染性荨麻疹与217例(49.66%)非感染性荨麻疹比较,中性粒细胞与淋巴细胞绝对值的比值以及血小板与淋巴细胞绝对值的比值差异有统计学意义(P<0.05),两组之间C反应蛋白与降钙素原比较差异有统计学意义(P<0.05)。AU转归为CU的可能危险因素有过敏史、血管性水肿以及既往罹患代谢性疾病与过敏性疾病(P<0.05)。结论AU住院患者常见的诱因主要是感染,除临床表现外,实验室检查中中性粒细胞与淋巴细胞绝对值的比值、血小板与淋巴细胞绝对值的比值、C反应蛋白、降钙素原等对判断AU患者有无感染有着重要的参考价值。AU进展为CU的可能危险因素包括:过敏史、血管性水肿以及既往罹患代谢性疾病与过敏性疾病,在临床中对于判断患者病情会有所帮助。

Objective To analyze the inducement,clinical features,laboratory examination results and treatment reaction of acute urticaria,and the possible risk factors of its turning into chronic urticaria.Methods Clinical data were collected from 437 inpatients with acute urticaria,who were hospitalized at the Department of Dermatology,Southwest Hospital,Army Medical University from January 2013 to May 2020.Results Among 437 patients,the mean age was 32.54±16.71 years old.The ratio of male to female was 1:2.26.In more detail,288 cases(65.90%)could accurately inform the inducement,and 203 cases(46.45%)were induced by infection or medication after infection.In 437 cases,220 cases(50.34%)of infectious urticaria were compared with 217 cases(49.66%)of non-infectious urticaria,and the ratio of absolute value of neutrophils to lymphocytes and the ratio of absolute value of platelets to lymphocytes were significantly different(both P<0.05).And of the two groups,there was statistically significant difference between CRP and procalcitonin(both P<0.05).The possible risk factors of acute urticaria turning into chronic urticaria were allergic history,angioedema and past medical history,including metabolic diseases and allergic diseases(all P<0.05).Conclusion The common inducement of acute urticaria is infection.Besides clinical manifestations,the ratio of absolute value of neutrophils to lymphocytes,the ratio of absolute value of platelets to lymphocytes,C-reactive protein,procalcitonin,etcin laboratory examination results have important reference value for judging whether acute urticaria patients are infected or not.The possible risk factors for the development of acute urticaria turning into chronic urticaria include allergic history,angioedema and past medical history,including metabolic diseases and allergic diseases,which will be helpful for judging the patient's condition in clinic.