动物蛋白饮食对过敏性紫癜患儿预后的影响分析

尹东豪, 郭亚丽, 曹童童, 潘长鹭, 赵高洁, 胡艳

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (9) : 927-932.

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (9) : 927-932. DOI: 10.7499/j.issn.1008-8830.2106126
论著·临床研究

动物蛋白饮食对过敏性紫癜患儿预后的影响分析

  • 尹东豪1, 郭亚丽1, 曹童童1, 潘长鹭2, 赵高洁1, 胡艳1
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Effect of animal protein diet on the prognosis of children with Henoch-Sch?nlein purpura

  • YIN Dong-Hao, GUO Ya-Li, CAO Tong-Tong, PAN Chang-Lu, ZHAO Gao-Jie, HU Yan
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摘要

目的 观察动物蛋白饮食与过敏性紫癜(Henoch-Sch?nlein purpura,HSP)复发/皮疹反复的关系,并分析HSP复发的相关危险因素,为临床防治提供依据。 方法 前瞻性选取北京儿童医院2020年10~12月收治的HSP患儿共121例为研究对象,予统一饮食医嘱(无新发皮疹1周后可添加动物蛋白类饮食),门诊随访半年。根据实际有/无摄入动物蛋白饮食,分为观察组(65例)和对照组(56例),记录两组患儿随访期间皮疹反复次数、HSP复发例数及新发肾损害例数;根据病情是否复发,分为复发组(32例)和未复发组(89例),通过食物频率调查问卷记录两组患儿每日动物蛋白摄入量。采用多因素logistic回归分析探讨儿童HSP复发的危险因素。 结果 观察组和对照组的皮疹反复次数、HSP复发率及肾损害发生率比较,差异均无统计学意义(P>0.05);复发组与未复发组患儿的每日动物蛋白摄入量比较,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,初次发病伴肾损害、初次治愈后呼吸道感染、初次治愈后未运动控制均为儿童HSP复发的独立危险因素(P<0.05)。 结论 动物蛋白饮食与HSP复发或皮疹反复无明显相关性。及时治疗肾脏损害、治愈后避免感染、限制剧烈运动,有助于降低儿童HSP的复发率。 引用格式:

Abstract

Objective To study the association of animal protein diet with the recurrence of Henoch-Sch?nlein purpura (HSP)/skin rash and the risk factors for recurrence of HSP. Methods A prospective analysis was performed for 121 children with HSP who were admitted to the Beijing Children's Hospital from October to December 2020. The children were given the doctor's advice of the same diet (animal protein diet could be added after 1 week without new-onset skin rash). Follow-up was performed at the outpatient service for half a year. According to the presence or absence of animal protein intake, the children were divided into an observation group with 65 children and a control group with 56 children. The times of skin rash recurrence, the incidence of HSP recurrence, and the incidence of kidney injury were compared between the two groups. According to the presence or absence of recurrence, the children were divided into a recurrence group with 32 children and a non-recurrence group with 89 children. A questionnaire on food frequency was used to record the daily intake of animal protein in the two groups. A multivariate logistic regression analysis was used to identify the risk factors for recurrence of HSP in children. Results There was no significant difference between the observation and control groups in the times of skin rash recurrence, the incidence rate of HSP recurrence, and the incidence rate of kidney injury (P>0.05). There was no significant difference in the daily intake of animal protein between the recurrence and non-recurrence groups (P>0.05). The multivariate logistic regression analysis showed that presence of kidney injury at initial onset, respiratory infection after cure for the first time, and lack of exercise control after cure for the first time were independent risk factors for the recurrence of HSP in children (P<0.05). Conclusions There is no significant association between animal protein diet and the recurrence of HSP or skin rash. Timely treatment of kidney injury, avoidance of infection after cure, and limitation of strenuous exercise may help to reduce the recurrence rate of HSP in children. Citation:

关键词

过敏性紫癜 / 动物蛋白饮食 / 皮疹反复 / 复发 / 危险因素 / 儿童

Key words

Henoch-Sch?nlein purpura / Animal protein diet / Skin rash recurrence / Recurrence / Risk factor / Child

引用本文

导出引用
尹东豪, 郭亚丽, 曹童童, 潘长鹭, 赵高洁, 胡艳. 动物蛋白饮食对过敏性紫癜患儿预后的影响分析[J]. 中国当代儿科杂志. 2021, 23(9): 927-932 https://doi.org/10.7499/j.issn.1008-8830.2106126
YIN Dong-Hao, GUO Ya-Li, CAO Tong-Tong, PAN Chang-Lu, ZHAO Gao-Jie, HU Yan. Effect of animal protein diet on the prognosis of children with Henoch-Sch?nlein purpura[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(9): 927-932 https://doi.org/10.7499/j.issn.1008-8830.2106126

参考文献

1 Barut K, Sahin S, Kasapcopur O. Pediatric vasculitis[J]. Curr Opin Rheumatol, 2016, 28(1): 29-38. PMID: 26555448. DOI: 10.1097/BOR.0000000000000236.
2 刘雅婷, 卢思广. IgA血管炎免疫学发病机制的研究进展[J]. 中国当代儿科杂志, 2017, 19(7): 837-841. PMID: 28697842. PMCID: PMC7389925. DOI: 10.7499/j.issn.1008-8830.2017.07.021.
3 Trapani S, Micheli A, Grisolia F, et al. Henoch-Sch?nlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature[J]. Semin Arthritis Rheum, 2005, 35(3): 143-153. PMID: 16325655. DOI: 10.1016/j.semarthrit.2005.08.007.
4 Bai LP, Yu J, Sun YX, et al. Efficacy of montelukast for the treatment of pediatric allergic purpura[J]. Medicine (Baltimore), 2019, 98(39): e17239. PMID: 31574836. PMCID: PMC6775355. DOI: 10.1097/MD.0000000000017239.
5 Lei WT, Tsai PL, Chu SH, et al. Incidence and risk factors for recurrent Henoch-Sch?nlein purpura in children from a 16-year nationwide database[J]. Pediatr Rheumatol Online J, 2018, 16(1): 25. PMID: 29661187. PMCID: PMC5902957. DOI: 10.1186/s12969-018-0247-8.
6 蔡明阳, 任献青, 李盼盼, 等. 基于食复理论探讨小儿过敏性紫癜阶梯饮食护理方案[J]. 湖南中医药大学学报, 2019, 39(10): 1259-1262. DOI: 10.3969/j.issn.1674-070X.2019.10.019.
7 吕秀平. 儿童过敏性紫癜的饮食控制与护理[J]. 世界最新医学信息文摘, 2019, 19(2): 212-213. DOI: 10.19613/j.cnki.1671-3141.2019.02.148.
8 Jacobi M, Lancrei HM, Brosh-Nissimov T, et al. Purpurona: a novel report of COVID-19-related Henoch-Sch?nlein purpura in a child[J]. Pediatr Infect Dis J, 2021, 40(2): e93-e94. PMID: 33201063. DOI: 10.1097/INF.0000000000003001.
9 商丽红, 周梦瑶, 熊励晶, 等. 腹型过敏性紫癜儿童肠内营养治疗方案的选择[J]. 中国当代儿科杂志, 2021, 23(2): 111-115. PMID: 33627202. PMCID: PMC7921529. DOI: 10.7499/j.issn.1008-8830.2010021.
10 中华医学会儿科学分会免疫学组, 《中华儿科杂志》编辑委员会. 儿童过敏性紫癜循证诊治建议[J]. 中华儿科杂志, 2013, 51(7): 502-507. DOI: 10.3760/cma.j.issn.0578-1310.2013.07.006.
11 Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides[J]. Ann Rheum Dis, 2006, 65(7): 936-941. PMID: 16322081. PMCID: PMC1798210. DOI: 10.1136/ard.2005.046300.
12 王文鹏, 程红, 赵小元, 等. 北京市儿童青少年食物频率问卷的信度和效度研究[J]. 中国儿童保健杂志, 2016, 24(1): 8-11. DOI: 10.11852/zgetbjzz2016-24-01-03.
13 胡海玉, 鹿玲. 过敏性紫癜患儿复发与反复的危险因素分析[J]. 实用儿科临床杂志, 2012, 27(21): 1663-1665. DOI: 10.3969/j.issn.1003-515X.2012.21.015.
14 Fikse DJ, Grenz PM, Wheatley SM, et al. Posterior reversible encephalopathy syndrome associated with Henoch Schonlein purpura in a pediatric patient[J]. Am J Emerg Med, 2021, 43: 291.e5-291.e7. PMID: 33097321. DOI: 10.1016/j.ajem.2020.10.024.
15 Trnka P. Henoch-Sch?nlein purpura in children[J]. J Paediatr Child Health, 2013, 49(12): 995-1003. PMID: 24134307. DOI: 10.1111/jpc.12403.
16 徐彩虹. 儿童过敏性紫癜305例护理管理策略[J]. 广东医学, 2016, 37(z2): 270-272. DOI: 10.13820/j.cnki.gdyx.2016.s1.120.
17 王莉, 薛晚利, 毛华, 等. 深度水解蛋白奶粉对过敏性紫癜儿童营养状况的应用研究[J]. 中国儿童保健杂志, 2016, 24(7): 732-735. DOI: 10.11852/zgetbjzz2016-24-07-17.
18 杨美英, 房夏玲. 舒适护理在小儿过敏性紫癜中的应用观察[J]. 陕西医学杂志, 2016, 45(5): 641. DOI: 10.3969/j.issn.1000-7377.2016.05.060.
19 赵亚斌. 过敏性紫癜患儿复发或反复情况的影响因素分析[J]. 山西医药杂志, 2019, 48(12): 1463-1464. DOI: 10.3969/j.issn.0253-9926.2019.12.027.
20 Rigante D. Clinical overview of vasculitic syndromes in the pediatric age[J]. Eur Rev Med Pharmacol Sci, 2006, 10(6): 337-345. PMID: 17274537.
21 齐海花, 何磊, 黄占强, 等. 不同分型过敏性紫癜患者外周血Th1/Th2型细胞因子的相关性研究[J]. 河北医学, 2019, 25(6): 996-998. DOI: 10.3969/j.issn.1006-6233.2019.06.030.
22 Org E, Parks BW, Joo JWJ, et al. Genetic and environmental control of host-gut microbiota interactions[J]. Genome Res, 2015, 25(10): 1558-1569. PMID: 26260972. PMCID: PMC4579341. DOI: 10.1101/gr.194118.115.
23 Mahmood L, Zulfiqar F, Khalid S, et al. P200 management of Henoch-Sch?nlein purpura (HSP)[J]. Arch Dis Child, 2019, 104(Suppl 3): A238. DOI: 10.1136/archdischild-2019-epa.555.
24 戴本启, 张志梅, 王华好. 儿童过敏性紫癜复发的危险因素分析[J]. 海南医学, 2018, 29(9): 1239-1241. DOI: 10.3969/j.issn.1003-6350.2018.09.017.
25 王晨, 张守民, 李雪莉. 35例混合型过敏性紫癜复发因素分析[J]. 中国麻风皮肤病杂志, 2019, 35(5): 266-268. DOI: 10.12144/zgmfskin201905266.
26 郭海燕. 龋病干预与过敏性紫癜复发率的相关研究[J]. 中国药物与临床, 2020, 20(15): 2591-2592. DOI: 10.11655/zgywylc2020.15.051.
27 韦祝, 常静, 梁晓婷, 等. 影响儿童过敏性紫癜复发的临床相关危险因素及预防措施[J]. 中国中西医结合儿科学, 2017, 9(2): 164-166. DOI: 10.3969/j.issn.1674-3865.2017.02.024.
28 Byun JW, Song HJ, Kim L, et al. Predictive factors of relapse in adult with Henoch-Sch?nlein purpura[J]. Am J Dermatopathol, 2012, 34(2): 139-144. PMID: 22441366. DOI: 10.1097/DAD.0b013e3182157f90.
29 Guissa VR, Arag?o PA, Marques HH, et al. Chronic active Epstein-Barr virus infection mimicking Henoch-Sch?nlein purpura[J]. Acta Reumatol Port, 2010, 35(5): 513-517. PMID: 21245820.
30 Lim CSH, Lim SL. Henoch-Sch?nlein purpura associated with Mycoplasma pneumoniae infection[J]. Cutis, 2011, 87(6): 273-276. PMID: 21838081.
31 钱宇, 李秋平, 高凤, 等. 儿童过敏性紫癜合并肺炎支原体感染患儿外周静脉血Th17/Treg平衡性的检测及临床意义[J]. 中国小儿急救医学, 2021, 28(5): 401-404. DOI: 10.3760/cma.j.issn.1673-4912.2021.05.013.
32 于云和, 王冰. 减少运动量在过敏性紫癜治疗中的临床意义[J]. 吉林医学, 2015, 36(7): 1420-1421. DOI: 10.3969/j.issn.1004-0412.2015.07.097.

基金

北京市区域中医(专科)诊疗中心建设项目(2018-7-12)。

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