伴血管神经性水肿的过敏性紫癜患儿预后及治疗  

Prognosis and treatment of children in Henoch-Sch?nlein purpura with angioneurotic edema

作　　者：王佳佩 吴菱[2] 王天波[2] 郑吉卡 狄亚珍[2] 戴霞华[2] 

机构地区：[1]宁波大学医学院,浙江宁波315211 [2]宁波市妇女儿童医院小儿风湿免疫科,浙江宁波315211

出　　处：《临床荟萃》2017年第1期68-70,共3页Clinical Focus

基　　金：宁波市医学科技项目(2015[50014]);浙江省重点平台科研项目(2015ZDA027);宁波市自然基金项目(2014A610280;2016A610172)

摘　　要：目的观察伴血管神经性水肿的过敏性紫癜(HSP)患儿应用不同治疗方法对改善其预后的影响。方法回顾分析HSP住院患儿1 012例,详细记录住院初始及随访的临床资料。将HSP患儿根据血管神经性水肿发生与否分A、B组,再将A组根据不同治疗方案分A1(常规治疗+低分子肝素钙)、A2组(常规治疗+双嘧达莫),比较不同组临床指标、实验室指标、紫癜性肾炎(HSPN)发生率等情况。结果本研究HSP患儿发生血管神经性水肿402例(39.7%)。A组血D-二聚体水平、皮疹反复率、HSPN发生率均高于B组(P均<0.05)。治疗后A1组血管神经性水肿消失时间早于A2组,血D-二聚体水平、皮疹反复率、HSPN发生率均低于A2组(P均<0.05)。结论伴血管神经性水肿的HSP患儿血液高凝状态明显,是疾病反复和HSPN的高发人群,早期积极予低分子肝素钙抗凝等治疗能迅速缓解病情、减少复发、改善预后。Objective To explore the influence of different therapies in children of Henoch-Schnlein purpura（HSP）with angioneurotic edema.Methods Retrospectively study was performed on 1 012 cases with HSP,including onset patterns,clinical manifestations and outcomes.According to HSP children with angioneurotic edema or not,the patients were divided into two groups：group A and B.With different therapies,group A subdivided into A1（treated with conventional therapy plus low molecular mass heparin calcium）and A2（treated with conventional therapy plus dipyridamole）.Comparison was made in the different sets of clinical indicators,laboratory indicators,and incidence rate of HSP nephritis（HSPN）.Results Of 1 012 cases,402（39.7%）patients had angioneurotic edema.The blood Ddimer level,the rash recurrence and HSPN incidence of group A were significantly lower than those of group B（P〈0.05）.After treatment,the angioneurotic edema in group A1 disappeared earlier than A2.The blood D-dimer level,the rash recurrence and HSPN incidence of group A1 were significantly lower than those of group A2（P〈0.05）.Conclusion HSP patients with angioneurotic edema had a high incidence of HSPN because of the blood hypercoagulable state.And low molecular mass heparins calcium in early use can help relieve pain,reduce recurrence and have good prognosis.

关 键 词：紫癜 过敏性 血管性水肿 治疗 预后 

分 类 号：R593.2[医药卫生—内科学]