过敏性紫癜肾脏损害的临床因素分析  

Analysis of clinical correlated factors of renal damage in Henoch-Schonlein purpura

作　　者：陈沫[1] 周传新[1] 郑裕娜[1] 

机构地区：[1]中山大学附属第五医院儿科,广东珠海519000

出　　处：《临床和实验医学杂志》2008年第10期21-22,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨过敏性紫癜肾脏损害的临床因素。方法回顾性分析72例过敏性紫癜患儿的临床资料,根据尿常规检查,分为尿检正常组和紫癜肾损害组;紫癜肾损害组分为一过性尿异常组及持续性尿异常组。观察相应的临床因素,并行统计学分析。结果紫癜肾损害组年龄,皮疹反复、皮疹持续时间,消化道出血的发生率及严重程度均高于尿检正常组,差异有显著性(P<0.05)。持续性尿异常组皮疹持续时间、血尿并蛋白尿发生率均高于一过性尿异常组,差异有显著性(P<0.05)。单纯皮肤紫癜者、紫癜加关节症状者、紫癜加消化道症状者以及同时有紫癜、关节症状和消化道症状者肾损害发生率分别是33.3%、41.7%、54.5%和75.0%,混合型和单纯紫癜者肾损害发生率的差异有显著性(P<0.01)。结论发病年龄较大,皮疹反复及持续时间长,消化道出血者易发生肾损害;除皮肤紫癜外,合并关节症状和消化道症状者易发生肾损害;皮疹持续时间长、血尿合并蛋白尿与肾脏持续受累有关。Objective To study the clinical correlated factors of renal damage in Henoch - Schonlein purpura （HSP）. Methods Seventy - two HSP children were reviewed and analyzed. According to the routine urianlysis, the patients were divided into HSP with renal damage group and HSP without renal damage group. HSP with renal damage group was further divided into the group with temporary abnormal urine findings and the group with persistent abnormal urine findings. Clinical correlated factors were then analyzed. Results There were differences in age, rash lasting time, relapse of rash and hemorrhage of digestive tract between the group of HSP with renal damage and group without renal damage （ P 〈 0.05 ）. Compared with the group of HSP with temporary urinary abnormality, longer rash lasting time, and higher incidence rate of hematuria with proteinuria were found in the group of HSP with persistent abnormal urinary abnormality （ P 〈 0.05）. The incidence rates of renal injury in HSP patients with skin purpuric lesion only, with purpura and joint symptom, with purpura and gastrointestinal tract symptom, and prupura combined with all the above symptoms were 33.3% , 41.7% , 54.5% and 75.0% respectively （ P 〈 0.01 ） ： Conclusion The elder children and the patients with long lasting or relapsing rash, with hemorrhage of digestive tract or with purpuric lesion and gastrointestinal tract symptom and joint symptom arepredisposed to renal injury. Long - lasting purpuric lesion, hematuria and proteinuria appear to be predictive for persistent renal damage.

关 键 词：过敏性紫癜 肾损害 儿童 

分 类 号：R725.5[医药卫生—儿科] R726.9[医药卫生—临床医学]