摘要
目的探讨与过敏性紫癜(HSP)患儿肾脏疾病相关的危险因素,为临床改善这种疾病提供靶目标。方法回顾性分析2014年2月-2016年2月在南阳南石医院确诊的HSP患儿的临床资料,运用单因素和多因素分析方法研究患儿出现肾脏损伤的危险因素。结果在945例HSP患儿中,其中44.76%为男性。患者出现了下列典型症状:可触及HSP(100.00%),持续性可触及紫癜(30.37%),关节炎(68.99%),腹痛(61.16%),肾炎(50.79%),严重腹痛(32.22%),胃肠道出血(12.70%)和血清IgA水平升高(40.42%)。另有32.58%的患儿服用了皮质类固醇,1.16%的患儿接受了静脉注射球蛋白。在所有480例HSP肾炎患者中:出现了血尿(30.26%),蛋白尿(7.20%);血尿和蛋白尿(11.01%),肾病综合征(1.16%),肾功能不全(1.16%);肾炎(70.05%),急性肾炎(2.01%)症状。通过比较HSP和HSP肾脏损伤患儿发现严重腹痛(P=0.005)、胃肠道出血(P=0.049)、和服用皮质类固醇(P=0.001)与HSP肾炎的相关性显著高于对照组,但性别、发病年龄、关节炎和血清中IgA含量与对照组比较差异无统计学意义(P>0.05)。多因素Logistic方法分析结果显示与HSP肾炎相关的变量是严重腹痛和服用类固醇(P<0.05),这两个变量可以解释HSP患儿肾脏损伤变化的64.2%。而年龄、持续性紫癜和消化道出血与HSP肾损伤无明显的相关性。结论严重腹痛和服用类固醇是HSP肾脏损伤的风险因素,可成为临床上预测HSP肾脏损伤的重要参数。
Objective In order to explore the risk factors associated with renal disease in the children with Henoch-Schonlein purpura(HSP),and to provide a target for clinical improvement of the disease. Methods The clinical data of children with HSP diagnosed in Nanshi Hospital of Nanyang from February 2014 to February 2016 were analyzed retrospectively. The risk factors of nephritis in HSP were analyzed by single factor and multiple factor analyses. Results Among 945 children with HSP,44.76% of them were male. Typical clinical symptoms were observed:palpable purpura(100%),persistent palpable purpura(30.37%),arthritis(68.99%),abdominal pain(61.16%),nephritis(50.79%),severe abdominal pain(32.22%),gastrointestinal bleeding(12.70%),and elevated serum IgA(40.42%). Besides,32.58% of children took corticosteroids,and 1.16% received intravenous gamma immunoglobulin. In all 480 cases of HSP nephritis,hematuria(30.26%),proteinuria(7.20%),hematuria and proteinuria(11.01%),nephrotic syndrome(1.16%),renal insufficiency(1.16%),nephritis(70.05%) and acute nephritis(2.01%) were detected. By comparing the children with HSP and HSP renal injury,it was found that the severity of abdominal pain(P=0.005),gastrointestinal bleeding(P=0.049),and administration of corticosteroids(P=0.001) in children with nephropathy were significantly different from those in the control group,but these two groups were similar in gender,disease onset age,arthritis,and IgA level in the serum. Multivariate logistic analysis showed that the variables associated with HSP nephritis were severe abdominal pain and steroid administration(P<0.05),which could account for 64.2% of the changes in children with HSP and nephritis. There was no significant correlation between age,persistent purpura,gastrointestinal bleeding and HSP renal injury. Conclusion Severe abdominal pain and steroid administration are risk factors associated with renal injury in HSP,and could serve as the key parameters to predict kidney injury in HSP clinically.
作者
吴云刚
何方
Wu Yungang;He Fang(Nanshi Hospital of Nanyang,Nanyang 473000,China;Nanyang Medical College,Nanyang 473000,China)
出处
《中国中西医结合皮肤性病学杂志》
CAS
2019年第5期397-400,共4页
Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine
关键词
过敏性紫癜
肾脏损伤
严重腹痛
类固醇
危险因素
Henoch-Schonlein purpura
Kidney injury
Severe abdominal pain
Steroid
Risk factors
作者简介
通信作者:何方,E-mail:987061803@qq.com。
