以腹痛为首发症状的儿童过敏性紫癜早期诊断分析  

Analysis on Henoch-Schonlein purpura with main fast symptom of abdominal pain of children

作　　者：邓素娟[1] 朱美华[1] 

机构地区：[1]广州医学院第二附属医院儿科,广东广州510260

出　　处：《中国现代医学杂志》2009年第23期3638-3640,3643,共4页China Journal of Modern Medicine

摘　　要：目的探讨以腹痛为首发症状的儿童过敏性紫癜(HSP)的临床特征和实验室检查特点,为该病早期诊断提供依据。方法对28例以腹痛为首发症状的儿童过敏性紫癜的临床资料进行回顾分析。结果28例患儿的腹痛部位多变而不固定,症状严重而腹部体征轻微,无明显腹肌紧张及反跳痛。腹痛发生后1～29d皮肤出现紫癜。血白细胞升高23例(82.1%);血清白蛋白降低21例(75.0%);血清C-反应蛋白(CRP)升高18例(64.3%);血沉增快18例(64.3%);大便潜血阳性25例(89.3%);③12例行胃镜检查100%出现异常,特异性改变为胃黏膜散在的斑片状略高出黏膜表面的大小不一出血斑点,部分融合成片。结论腹痛部位多变而不固定,症状严重而腹部体征轻微,血WBC、CRP升高、血沉增快、血清白蛋白降低、大便潜血阳性,以及特征性的胃黏膜改变是儿童腹型过敏性紫癜的临床表现及检查特征。【Objective】To discuss the clinical manifestations and the characteristics of laboratory in Henoch-Schonlein purpura of children with fast main symptom of abdominal pain.【Methods】28 cases of such patient were treated in our hospital and the materials were analyzed retrospectively. 【Results】The change of position and non-fix of abdominal pain and the clinical manifestations were serious, but the abdominal signs was slight, non-tenderness abdominal muscle and non-rebound tenderness in that＇s patients. After abdominal pain showed 1 to 29 days,the skin showed purpura. The count of leukocytes in peripheral blood was high in 23 eases, the level of serum albumin was low in 21 eases, the level of serum ClIP was high in 18 cases. The ESR was fast in 18 eases and fatal oecult blood test was positive in 25 eases. 12 eases were checked by gastroscopy, the result showed abnormal. It,s characteristics change was gastric-mucous hemorrhage spot. [ Conclusions ] The clinical manifestations were change of position and non-fix of abdominal pain and the clinical manifestations were serious, but the abdominal signs was slight in Henoeh-Sehonlein purpura of children with fast main symptom of abdominal pain. The characteristics changed of laboratory was higher of tile count of leukoeytes in peripheral blood and serum CRP, faster of ESR, lower of serum albumin, positive of faeal occult blood test and the characteristics changed of gastric-mucous in that＇s patients.

关 键 词：儿童 过敏性紫癜 腹痛 临床特征 胃镜 

分 类 号：R554.6[医药卫生—血液循环系统疾病]