儿童IgA血管炎不同脏器并发症5例并文献复习  

Complications of IgA vasculitis in different organs in 5 children and literature review

作　　者：丁乐乐 丁樱[1,2] 魏金辉 徐闪闪[2] 梅晓峰[1] 李金刚[1] DING Lele;DING Ying;WEI Jinhui;XU Shanshan;MEI Xiaofeng;LI Jingang(Pediatric Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Zhongmu County People′s Hospital,Zhengzhou 451450,China)

机构地区：[1]河南中医药大学第一附属医院儿科医院,郑州450000 [2]河南中医药大学儿科医学院,郑州450000 [3]中牟县人民医院重症医学科,郑州451450

出　　处：《中国中西医结合儿科学》2024年第4期314-319,共6页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(82305311,82305310);国医大师工作室建设项目(国中医药人教发〔2022〕245号);河南省特色骨干学科中医学第二批学科建设项目(STG-ZYX03-202119,STG-ZYX05-202140)。

摘　　要：目的分析儿童IgA血管炎的临床特点,提高对其的认识和诊治水平。方法回顾性分析2018年4月至2021年4月河南中医药大学第一附属医院儿科收治的5例儿童IgA血管炎的临床特征、辅助检查、治疗转归等。结果5例IgA血管炎中,男4例,女1例;中位年龄6岁。肺损害1例,肝损害1例,脾损害1例,肠腔损害1例,附睾损害1例。病程中出现腹痛4例,关节疼痛2例,所有患儿均有典型皮肤紫癜。尿检正常2例,伴尿检异常3例,其中单纯蛋白尿型1例,血尿兼蛋白尿型2例。所有患儿经中西医结合治疗后均好转。结论IgA血管炎是儿童时期最常见的以IgA沉积为主的血管炎性病变,除紫癜外,腹痛、关节肿痛是其最常见的临床表现,易合并其他脏器损伤,甚至危及生命,如严重的肺损伤,当患者出现其他系统症状时,应及时完善相关检查以明确病情,避免延误治疗时机。Objective To improve the understanding of IgA vasculitis and the level of diagnosis and treatment by analyzing its clinical characteristics in children.Methods Retrospectively analyze the clinical characteristics,auxiliary examinations,treatment and prognosis of the 5 children with IgA vasculitis admitted to the Department of Pediatrics of the First Affiliated Hospital of Henan University of Chinese Medicine from April 2018 to April 2021.Results There were 4 males and 1 female in 5 cases of IgA vasculitis.The median age was 6.There was 1 case of lung damage,1 case of liver damage,1 case of spleen damage,1 case of intestinal damage and 1 case of epididymis damage.During the course of the disease,4 cases had abdominal pain and 2 cases had joint pain.All children had typical skin purpura.There were 2 cases without abnormalities in urine testing and 3 cases with abnormalities in urine testing,including 1 case of simple proteinuria and 2 cases of hematuria and proteinuria.All children were improved after treatment with integrated traditional Chinese and Western medicine.Conclusion IgA vasculitis is the most common vascular inflammatory disease dominated by IgA deposition in childhood.In addition to purpura,abdominal pain and joint swelling and pain are the most common clinical manifestations.The disease is very likely to combine other organ damage and it′s even life-threatening,such as severe lung injury.When patients have other systemic symptoms,relevant examinations should be completed in time to clarify the condition and to avoid treatment delay.

关 键 词：IgA血管炎 器官 组织 合并症 回顾性研究 儿童 

分 类 号：R725.4[医药卫生—儿科]