探讨儿童过敏性紫癜肾脏损害危险因素的临床意义  

Clinical significance of renal damage risk factors analysis for henoch-schonlein purpura in children

作　　者：蒙海强[1] 王玲[1] 莫坚[1] 何海英[1] 麦恒风[1] 

机构地区：[1]广西医科大学第九附属医院儿科,广西北海536000

出　　处：《中国现代医学杂志》2011年第30期3830-3833,共4页China Journal of Modern Medicine

摘　　要：目的分析儿童过敏性紫癜（HSP）继发肾损害的临床相关因素,旨在探讨危险因素,为临床判断病情及预后提供依据。方法回顾性分析2008年1月～2009年12月期间178例过敏性紫癜住院病例,采集患儿性别、年龄、发病诱因、临床表现及实验室指标等资料,将各相关因素对肾损害的影响,分别进行单因素χ~2检验和多因素Logistic回归分析。结果 178例HSP患儿中有117例（65.7%）出现肾脏损害,初次发病皮肤紫癜持续时间〉4周及皮肤紫癜的反复次数〉3次、年龄≥8岁、初发未使用肝素治疗、年内反复发病2次以上等因素与HSP肾脏损害发生有密切关系,Logistic回归分析具有统计学意义（P〈0.05）。结论 HSP年长患儿、皮疹持续时间长及反复发作是不容忽视的危险因素,临床严密监测血小板、血清IgM值、尿常规等,初发治疗及时采取抗凝措施,有利于预防该病反复发作,及早预防肾损害的发生和发展。[ Objectives ] Analyze clinical factors of secondary renal damage towards children with HSP in order to find high risk factors that have positive impact towards tendency of renal damage occurrence. The result can be used as good input for clinical diagnosis and prognosis of the disease. [Methods ] Evaluated retrospectively of 178 HSP cases from Jan 2008 to Dec 2009 in pediatrics department of our hospital. Sex, age, predisposing factor, clinical manifestations and laboratory data etc were collected as candidate impact factors. Univariat X^2 test and multivariate Logistic regression analysis were performed towards these factors. [Results] Of 117 among 178 ＇HSP patients （65.7%） who had got renal damage-the attacks skin purpura duration 〉4 weeks, the number of skin purpura repeated 〉3 times, their ages ≥ 8 years old, heparin treatment was not performed at the initial phase and years of two above frequency of HSP attack had positive impacts towards the occurrence of renal damage. Logistic regression analysis result was statistically significant （P 〈0.05）. [ Conclusion ] Older children, with long lasting or relapsing rash are high risk factors towards renal damage that can not be neglected, clinical monitoring of platelet, serum IgM values and routine urine test result etc closely, taking anticoagulation therapy timely at the first occurrence can help proactively preventing recurrence of the disease and the occurrence and continuation of renal damage.

关 键 词：儿童 过敏性紫癜 危险因素 

分 类 号：R725[医药卫生—儿科]