兒童過敏性紫癜50例臨床分析

Henoch-Schönlein purpura in children:clinical analysis of 50 cases

目的瞭解本地區兒童過敏性紫癜的臨床特徵。方法對50例過敏性紫癜住院患兒臨床資料、隨訪情況進行回顧性分析。結果1.平均發病年齡(6.0±2.7)歲,80%患兒於秋冬季節發病,44%患兒有明確誘因,以上呼吸道感染為主。2.所有患兒均有典型皮膚紫癜,分佈於下肢、臀部,94%患兒以皮膚紫癜首發,少數以關節及胃腸道為首發症狀後出疹。關節及胃腸道症狀發生率分別為38%和32%。紫癜性腎炎發生率為8%,臨床上主要表現為鏡下血尿和微量白蛋白尿。3.伴有腹痛或關節痛的患兒早期激素使用率為88%,未發現腸套疊、腸梗阻及腸穿孔等嚴重胃腸道併發症。結論過敏性紫癜為兒童常見血管炎,有其本身臨床特徵及發病規律。

Objective To study the clinical features in our local children affected with Henoch-Schönlein purpura(HSP).Methods Analyzed retrospectively the clinical features of children admitted with a diagnosis of HSP in our hospital.Results(1)50 children entered the study,mean age of onset(6.3±2.1)years,80%patients developed HSP during the autumn and winter.44%patients of the HSP patients revealed evident predisposing factors,mainly upper respiratory infection.(2)All the patients had typical purpura as the presenting sign,the distribution of purpura in the lower extremities and buttock.94%of the patients had the purpura initially.A few patients presented the arthritis and gastrointestinal symptoms initially and then developed the purpura.Gastrointestinal involvement and arthritis occurred in 38%and 32%.8%developed HSP nephritis manifested as microscopic hematuria and microproteinuria.3.88%of patients presented abdominal pain or arthritis received the steroid treatment in early stage.No severe gastrointestinal complication such as intussusceptions,intestinal obstruction or perforation was found.Conclusion HSP in children has its own clinical and episodic features.