过敏性紫癜患儿肾损伤与呼吸道病毒感染的关系及其影响因素分析  

Relationship between renal injury and respiratory virus infection in children with Henoch-Schonlein purpura and its infl uencing factors

作　　者：赵子年 张颖[2] 刘力铭[2] 朱键 ZHAO Zinian;ZHANG Ying;LIU Liming;ZHU Jian(Department of Pediatric Hematology and Oncology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China;Department of Pediatric Renal Rheumatology and Immunology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China;Department of Children's Respiratory Medicine,Hubei Maternal and Child Health Hospital,Wuhan 430070,China)

机构地区：[1]唐山市妇幼保健院小儿血液肿瘤科,河北唐山063000 [2]唐山市妇幼保健院小儿肾脏风湿免疫科,河北唐山063000 [3]湖北省妇幼保健院儿童呼吸内科,武汉430070

出　　处：《长春中医药大学学报》2023年第2期205-208,共4页Journal of Changchun University of Chinese Medicine

基　　金：河北省卫生厅科研基金项目(20191535)。

摘　　要：目的 分析过敏性紫癜患儿肾损伤与呼吸道病毒感染的关系及其影响因素。方法 回顾性收集278例过敏性紫癜患儿临床资料,根据患儿是否发生肾损伤分为损伤组(56例)和未损伤组(222例),统计2组呼吸道病毒感染情况及过敏性紫癜患儿肾损伤发生的单因素,采用多因素Logistic回归分析过敏性紫癜患儿肾损伤发生的危险因素。结果 损伤组总呼吸道病毒感染率(64.29%,36/56)显著高于无损伤组(43.69%,97/222)(P <0.05)。单因素分析结果显示,损伤组与未损伤组年龄<7岁、反复皮疹时间≥1个月、消化道出血、关节肿痛、呼吸道病毒感染、埃-巴二氏病毒(EBV)感染、外周血血小板(PLT)、白细胞(WBC)水平升高、血清D-二聚体(D-d)、免疫球蛋白A(IgA)水平升高患者占比比较,差异具有统计学意义(P <0.05)。多因素Logistic回归分析结果显示,反复皮疹时间≥1个月、呼吸道病毒感染、EBV感染、外周血PLT、WBC水平升高、血清D-d、IgA水平升高均为过敏性紫癜患儿肾损伤的独立危险因素(OR=1.605、2.174、3.051、2.92、2.69、4.462、2.776,P <0.05)。结论 过敏性紫癜肾损伤患儿呼吸道病毒感染发生率较高,患儿肾损伤发生的危险因素包括反复皮疹时间≥1个月、呼吸道病毒感染、EBV感染、外周血PLT、WBC水平升高,血清D-d、IgA水平升高。Objective To analyze the relationship between the renal injury and respiratory virus infection in children with HenochSchonlein purpura and its infl uencing factors. Methods The clinical data of 278 children with Henoch-Schonlein purpura admitted to our hospital from January 2019 to December 2021 were retrospectively collected. They were divided into an injury group(56cases) and a non-injury group(222 cases) according to whether they suf fered from a kidney injury. The respiratory virus infection and the single factors for a kidney injury were counted in the two groups, and a multi-factor Logistic regression analysis was conducted on the risk factors for kidney injury in those child patients. Results The total respiratory virus infection rate in the injury group(64.29%, 36/56) was signifi cantly higher than that in the non-injury group(43.69%, 97/222)(P<0.05). The univariate analysis showed there was a statistically significant difference in the proportion of kidney injuries in patients with their age younger than 7, with their repeated rash lasting for more than one month, with the symptoms of gastrointestinal bleeding, joint swelling and pain, respiratory virus infection, Epstein-Barr virus(EBV) infection, and with the elevated levels of platelet(PLT),white blood cell(WBC) in peripheral blood, with the elevated levels of serum D-dimer(D-d), immunoglobulin A(IgA) in the two groups(P<0.05). The multivariate Logistic regression analysis showed that the time of repeated rash ≥ 1 month, respiratory virus infection, EBV infection, increased levels of PLT and WBC in peripheral blood, and the increased levels of serum D-d and IgA were all independent risk factors for renal injury in children with Henoch-Schonlein purpura(OR=1.605, 2.174, 3.051, 2.92, 2.69,4.462 and 2.776, P<0.05). Conclusion The incidence of respiratory tract virus infection in Henoch-Schonlein purpura children with renal injury is high, for which the risk factors include the time of repeated rash ≥ 1 month, respiratory tract virus infection, EBV i

关 键 词：过敏性紫癜 儿童 呼吸道病毒 肾损伤 因素 

分 类 号：R692[医药卫生—泌尿科学]