过敏性紫癜儿童肾脏损害预测因素的多元回归分析  

Multiple regression analysis for predictive factors of renal damage in children with Henoch-Schonlein purpura based on objective indicators

作　　者：寇敏[1] 赵丽君[1] 吴芳[1] 杨跃红[1] 薛彩红[1] Kou Min;Zhao Lijun;Wu Fang;Yang Yuehong;Xue Caihong(Department of Nephrology,Shanxi Children′s Hospital,Taiyuan 030013,China)

机构地区：[1]山西省儿童医院肾内科,太原030013

出　　处：《中国药物与临床》2020年第15期2502-2505,共4页Chinese Remedies & Clinics

摘　　要：目的探讨过敏性紫癜儿童肾脏损害的预测因素,从而为早期预防及干预过敏性紫癜儿童肾脏损害提供依据。方法收集2016年1月至2018年6月于我院肾内科住院首次确诊过敏性紫癜儿童220例临床病例资料,包括年龄、性别、临床类型、发病季节、抗链球菌溶血素O、血白细胞计数、中性粒细胞分类、淋巴细胞分类、血小板计数、C反应蛋白、红细胞沉降率、尿素、肌酐、D-二聚体、外周血免疫球蛋白(Ig)G、IgA、IgM、补体C3、补体C4等19个因素作为研究指标,通过病例对照研究设计,对过敏性紫癜肾脏损害组90例和无肾脏损害组130例进行Logistic回归分析,探讨过敏性紫癜儿童肾脏损害的危险因素。结果单因素分析显示2组患儿年龄、性别、临床类型、抗链球菌溶血素O、D-二聚体、外周血IgG、IgA等因素方面比较,差异有统计学意义(P<0.05);多因素Logistic回归显示年龄、性别、D-二聚体、外周血IgA是过敏性紫癜儿童肾脏损害的独立危险预测因素(P<0.05)。结论过敏性紫癜儿童,尤其是男性患儿,年龄≥6岁,密切监测D-二聚体、外周血IgA等危险预测因素,如有异常及时采取治疗措施避免肾脏损害。Objective To determine the predictive factors of renal damage in children with Henoch-Schonlein purpura,and to provide evidence for early prevention and intervention of renal damage in children with Henoch-Schonlein purpura.Methods The clinical data of 220 children with initial diagnosis of Henoch-Schonlein purpura in our hospital between January 2016 and June 2018 were retrieved for the study,including 19 variables(age,gender,clinical type,season of onset,antistreptolysin O,white blood cell count,neutrophils,lymphocyte subsets,platelet count,C-reactive protein,erythrocyte sedimentation rate,blood urea,serum creatinine,D-dimer,peripheral immunoglobulins IgG,IgA,IgM,complements C3 and C4).Using a case-control study design,Logistic regression analysis was performed for 90 cases of Henoch-Schonlein purpura nephritis(HSPN group)and 130 cases without the condition(non-HSPN group),so as to determine the risk factors of renal damage in these children.Results Univariate analysis showed statistically significant differences in age,gender,clinical type,antistreptolysin O,D-dimer,peripheral IgG and IgA between the two groups(P<0.05).Multivariate Logistic regression showed that age,gender,D-dimer,and peripheral blood IgA were independent risk predictors of HSPN(P<0.05).Conclusion For children with Henoch-Schonlein purpura,especially boys and those aged≥6 years,close monitoring of risk predictors such as D-dimer and peripheral blood IgA should be warranted.Abnormal findings of these indicators should prompt for timely treatment measures in order to avert renal damage.

关 键 词：紫癜 过敏性 儿童 肾脏损害 预测因素 

分 类 号：R726.9[医药卫生—儿科] R725.5[医药卫生—临床医学]