儿童过敏性紫癜合并消化道出血的影响因素分析

Analysis of influencing factors of allergic purpura complicated with alimentary tract hemorrhage in children

目的分析儿童过敏性紫癜合并消化道出血的影响因素。方法回顾性分析2018年2月至2021年2月本院收治的172例过敏性紫癜患儿的临床资料,根据是否合并消化道出血分为消化道出血组(62例)和非消化道出血组(110例)。采用多因素Logistic回归分析探究过敏性紫癜合并消化道出血的影响因素。结果两组的关节肿痛、皮疹分布部位≥3个、幽门螺旋杆菌(Hp)阳性占比及白细胞计数(WBC)、中性粒细胞计数(NEUT)、血小板计数(PLT)、血小板压积(PCT)、中性粒细胞/淋巴细胞比率(NLR)、C反应蛋白(CRP)水平、红细胞沉降率(ESR)比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高NLR、CRP是影响过敏性紫癜合并消化道出血的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,CRP诊断过敏性紫癜合并消化道出血的灵敏度、特异度为58.72%、85.11%;NLR诊断过敏性紫癜合并消化道出血的灵敏度、特异度为40.12%、82.25%。结论儿童过敏性紫癜合并消化道出血的可能危险因素为高NLR和CRP,临床应重视监测NLR和CRP变化,有助于提高对疾病的诊治效果,改善临床预后,值得推广。

Objective To analyze the influencing factors of allergic purpura complicated with alimentary tract hemorrhage in children.Methods The clinical data of 172 children with allergic purpura admitted in our hospital from February 2018 to February 2021 were retrospectively analyzed,and the children were divided into alimentary tract hemorrhage group(62 cases)and non-alimentary tract hemorrhage group(110 cases)according to whether they had alimentary tract hemorrhage.Multivariate Logistic regression analysis was used to explore the influencing factors of allergic purpura complicated with alimentary tract hemorrhage.Results There were statistically significant differences in joint swelling and pain,rash distribution site≥3,Helicobacter pylori(Hp)positive proportion,white blood cell count(WBC),neutrophilic granulocyte count(NEUT),platelet count(PLT),plateletcrit(PCT),neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP)level and erythrocyte sedimentation rate(ESR)between the two groups(P<0.05).Multivariate Logistic regression analysis showed that high NLR and CRP were the risk factors for allergic purpura complicated with alimentary tract hemorrhage(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity and specificity of CRP in the diagnosis of allergic purpura complicated with alimentary tract hemorrhage were 58.72%and 85.11%,respectively;the sensitivity and specificity of NLR in the diagnosis of allergic purpura complicated with alimentary tract hemorrhage were 40.12%and 82.25%.Conclusion The possible risk factors of allergic purpura complicated with alimentary tract hemorrhage in children are high NLR and CRP.Clinical attention should be paid to monitoring the changes of NLR and CRP,which is helpful to improve the diagnosis and treatment of the disease and improve the clinical prognosis,which is worth promoting.