过敏性紫癜并发心脏损害危险因素的巢式病例对照研究

A Nested Case-control Study on Risk Factors of Henoch-Sch nlein Purpura Complicated with Heart Damage

目的探讨过敏性紫癜(HSP)并发心脏损害的危险因素。方法采用巢式病例对照研究,选择2018年1月至2020年12月天门市第一人民医院治疗的280例HSP患儿的临床资料,将其中发生HSP并发心脏损害的55例患儿作为试验组,同时按照1∶4比例匹配220例HSP未发生心脏损害的患儿作为对照组,采用单因素和多因素Logistic回归分析HSP并发心脏损害的危险因素。结果试验组男性、发病前诱因、混合型HSP、高黏滞血症以及反复皮疹≥1个月比例高于对照组[69.09%(38/55)比47.73%(105/220)、70.91%(39/55)比49.09%(108/220)、60.00%(33/55)比35.91%(79/220)、65.45%(36/55)比41.89%(92/220)、56.36%(31/55)比32.73%(72/220)](P<0.01)。多因素Logistic回归分析结果显示,性别、发病前诱因、混合型HSP、高黏滞血症以及反复皮疹是HSP并发心脏损害的独立危险因素(OR=3.198,95%CI 1.597~6.404;OR=2.150,95%CI 1.079~4.281;OR=2.403,95%CI 1.251~4.617;OR=2.479,95%CI 1.269~4.844;OR=3.194,95%CI 1.635~6.243)(P<0.05或P<0.01)。结论男性、发病前诱因、混合型HSP、高黏滞血症以及反复皮疹≥1个月是HSP并发心脏损害的独立危险因素,在临床治疗中可根据具体影响因素制订相关措施,以减少HSP并发心脏损害的发生。

Objective To investigate the risk factors of Henoch-Sch nlein purpura(HSP)complicated with heart damage.Methods A nested case-control study was used to select the clinical data of 280 children with HSP treated in the First People′s Hospital of Tianmen City from Jan.2018 to Dec.2020.Among them,55 children with HSP complicated with cardiac damage were included as a test group.At the same time,220 children with HSP without cardiac damage were matched at the ratio of 1∶4 as a control group.Univariate and multivariate Logistic regression was used to analyze the risk factors of HSP complicated with cardiac damage.Results The proportions of males,predisposing factors,mixed HSP,hyperviscosity and recurrent rash≥1 month in the test group were higher than those in the control group[69.09%(38/55)vs 47.73%(105/220),70.91%(39/55)vs 49.09%(108/220),60.00%(33/55)vs 35.91%(79/220),65.45%(36/55)vs 41.89%(92/220),56.36%(31/55)vs 32.73%(72/220)](P<0.01).Multivariate Logistic regression analysis showed that gender,predisposing factors,mixed HSP,hyperviscosity and recurrent rash were independent risk factors for cardiac damage in children with HSP(OR=3.198,95%CI 1.597-6.404;OR=2.150,95%CI 1.079-4.281;OR=2.403,95%CI 1.251-4.617;OR=2.479,95%CI 1.269-4.844;OR=3.194,95%CI 1.635-6.243)(P<0.05 or P<0.01).Conclusion The male gender,predisposing factors,mixed HSP,hyperviscosity and recurrent rash for≥1 month are independent risk factors for cardiac damage in children with HSP.In clinical treatment,relevant measures can be formulated according to specific influencing factors to reduce the occurrence of cardiac damage complicated with HSP.