成人过敏性紫癜85例临床分析  

Clinical Analysis of 85 Cases of Henoch-Schonlein Purpura in Adult

作　　者：温杰[1] 杜三军[2] 王晓美[1] 吴远慧[1] 陈雷刚[1] 安国芝[1] WEN Jie;DU Sanjun;WANG Xiaomei;WU Yuanhui;CHEN Leigang;AN Guozhi(Department of Dermatology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Gastroenterology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院皮肤科,河北张家口075000 [2]河北北方学院附属第一医院消化内科,河北张家口075000

出　　处：《中国皮肤性病学杂志》2018年第12期1391-1395,共5页The Chinese Journal of Dermatovenereology

基　　金：张家口市科技攻关项目(1421106D)

摘　　要：目的探讨成人过敏性紫癜(HSP)的临床特点、预后情况及肾脏受累的相关危险因素。方法回顾性分析2014年1月-2016年1月于河北北方学院附属第一医院皮肤科就诊的85例HSP门诊或住院成人患者临床资料。根据患者肾脏受累情况分为肾脏受累组和非肾脏受累组,同期选取40例HSP患儿,比较不同年龄患者临床特点,并分析成人肾脏受累的危险因素。结果 (1)本组成人HSP患者主要发病年龄18～35岁(74. 12%,63/85),集中在冬、春季;上呼吸道感染及食物过敏为主要诱因;以皮肤损害为首发症状,混合型居多。(2)尿液检查:尿检异常(累及肾脏)者28例。(3)多因素Logistic回归分析结果,合并高血压、伴肾功能损害及皮疹反复是影响成人HSP患者肾脏受累的独立危险因素(P <0. 05),早期预防则是保护因素(P <0. 05)。结论成年HSP肾脏受累风险较大,多与皮疹反复、高血压、肾功能损害有关;早期预防能降低肾脏受累几率,需引起重视。Objective To investigate the clinical characteristics,prognosis and risk factors of renal involvement in adult patients with Henoch-Schonlein purpura (HSP).Methods The clinical data of 85 adult patients with HSP treated in the department of dermatology in the First Affiliated Hospital of Hebei North University from January 2014to January 2016were retrospectively analyzed.According to patient's renal involvement, it was divided into the kidney involvement group and the non-renal involvement group;meanwhile,40children cases.with HSP were enrolled to make a comparison of clinical characteristics of patients in different ages and to analyze the risk factors of renal involvement in adults.Results The majority of onset age in adult HSP group was 18-35years,and the onset season was mainly in winter and spring.Upper respiratory tract infection and food allergy were the main causes.Multiple skin lesions were the main initial symptoms,while there were joint damage or renal damage:The mixed type was the main clinical type.The urine test showed 28 cases with abnormal urine (renal involvement).Multivariate Logistic regression analysis showed that being complicated with hypertension,renal function damage and recurrent skin rash were independent risk factors of renal involvement in adult patients (P <0.05),and early prevention was the protective factor (P <0.05).Conclusion Adult patients with HSP has a high risk of renal involvement,which is mainly related to recurrent rash,hypertension and renal function damage.It is important to emphasize the early prevention as it can reduce the risk of renal involvement in patients with HSP.

关 键 词：过敏性紫癜 成人 临床特点 预后 影响因素 

分 类 号：R554.6[医药卫生—血液循环系统疾病]