儿童过敏性紫癜的临床特点及血淋巴细胞亚群的变化  

Clinical characteristics and changes of blood lymphocytes in children with Henoch-Schonlein Purpura

作　　者：朱永琴[1] 王其莉[1] 邬思远[1] 刘金凤[1] 董勤[1] 

机构地区：[1]浙江省中医院儿科,杭州310006

出　　处：《浙江医学》2013年第11期1031-1032,1040,共3页Zhejiang Medical Journal

摘　　要：目的探讨过敏性紫癜(HSP)患儿的临床特点及发病机制。方法对76例HSP患儿急性期的临床表现进行分析总结;并采用流式细胞仪分析技术及免疫比浊法对外周血淋巴细胞亚群(CD3、CD4、CD8、CD19、NK细胞)及血清补体C3进行检测,与30例健康儿童进行对照比较。结果 76例患儿中发病同时或发病前2周内有呼吸道感染62例(81.6%)。76例患儿均先后出现紫癜,以双下肢皮肤紫癜最多见,合并消化道症状56例(73.7%),其中以消化道症状为首发症状21例(27.6%);合并肾损害36例(47.3%),其以微量蛋白尿型、血尿和蛋白尿型为多见,肾病综合征型少见。HSP组急性期外周血CD4及NK细胞数量降低、CD19显著升高,与对照组比较,差异均有统计学意义(均P<0.01);血清补体C3增高,与对照组比较,差异有统计学意义(P<0.05);血CD8增高,但与对照组比较,差异无统计学意义(P>0.05)。结论 HSP患儿发病与呼吸道感染有密切关系,胃肠道症状为首发症状的比例较高,合并肾损害也较多,但以微量蛋白尿型、血尿和蛋白尿型为多见,预后良好。儿童HSP的发病与T、B淋巴细胞及NK细胞的功能紊乱有关,且补体系统也参与HSP的发病。Objective To review the clinical characteristics and blood lymphocyte subgroups in children with Henoch-Schonlein Purpura （HSP）. Methods The clinical manifestations and peripheral lymphocytes changes in 76 child pa- tients with HSP were analyzed. The percentage of CD3＋, CD4＋, CD8＋, CD19＋ and NK lymphocytes in peripheral blood were mea- sured by flow cytometry and serum level of C3 were measured by immuno-nephelometry in 76 HSP patients and 30 healthy con- trols. Results Among 72 HSP patients 62 （81.6%）had respiratory tract infection concurrently or within two weeks of HSP onset. All patients presented purpura in disease causes and purpura was presented mostly in two lower limbs. Fifty six cases （73.7%） had combined digestive tract symptoms, and 21 cases manifested only digestive tract symptoms initially. Kidney damages were combined in 36 cases （47.3%）; microalbuminuria, bloody urine and proteinuria were common, but nephrotic syndrome was rare. CD4 and NK lymphocytes in peripheral blood of HSP patients were significantly lower, CD19 lymphocytes were significantly higher than those in healthy controls （P〈0.01）. C3 in plasma was higher than that in healthy controls （P〈0.05） and there was no significant difference in CD8 lymphocytes between HSP and control groups（P 〉0.05）. Conclusion HSP has substantial connec- tion with respiratory tract infection. Digestive tract syndrome and kidney damages are common manifestations for HSP. Children with HSP usually have dysfunction of T, B and NK lymphocytes.

关 键 词：过敏性紫癜 临床特点 病因 发病机制 

分 类 号：R725.5[医药卫生—儿科]