
儿童过敏性紫癜临床特征分析(附184例报道)
黄文彦, 陈荣华, 甘卫华, 丁桂霞, 黄松明, 姜新猷
中国当代儿科杂志 ›› 2002, Vol. 4 ›› Issue (3) : 183-185.
儿童过敏性紫癜临床特征分析(附184例报道)
Clinical Features of Henoch Schnlein Purpura in Children: a Report of 184 Cases
目的 了解过敏性紫癜儿童的临床特征。方法:回顾性分析过敏性紫癜患儿184例,对其临床表现及特征进行分析。结果:①发病年龄均>2岁,平均发病年龄(7.8±2.6)岁;67.4%患儿于秋冬季节发病;62.5%患儿有明确诱因,以上呼吸道感染为主。②所有病人均有典型皮肤紫癜,分布于下肢(100%)、臀部(47.3%)、上肢(17.4%)等。89.1%患儿以皮肤紫癜首发,少数以胃肠道及关节症状为首发症状后2周内出疹,先出现肾脏损害而后出疹者罕见。胃肠道及关节症状发生率分别为60.9%和44.6%。紫癜性肾炎发生率为52.2%,临床上主要表现为血尿和(或)蛋白尿(68.8%),病理改变主要为Ⅰ~Ⅲ级(85.2%)。③44.0%病人血沉增快,24.1% ASO增高;63.7%病人IgA增高,IgG,IgM及补体绝大多数正常。结论:过敏性紫癜为儿童常见病,且有其本身临床特征及发病规律。
OBJECTIVE: To study the clinical features of Henoch Schonlein purpura (HSP) in Chinese children. METHODS: The clinical features of 184 children with HSP were analyzed retrospectively. RESULTS: ① The age of onset of all the 184 children with HSP was over two years and the mean age was ( 7.8 ± 2.6 ) years. Of the 184 children, 67.4% developed HSP during the fall and winter months; 62.5% of the HSP patients revealed evident predisposing factors, mainly upper respiratory infection. ② Of all the patients, 89.1% had typical purpura as the presenting cutaneous sign. The distribution of rash in the lower extremities, buttock and upper extremities was 100%, 47.3% and 17.4% , respectively. Gastrointestinal involvement and arthritis occurred in 60.9% and 44.6% , respectively. Of all the patients, 52.2% developed HSP nephritis manifested as isolated hematuria and/or proteinuria ( 68.8% ) and the main pathological types were grade Ⅰ~Ⅲ ( 85.2% ). ③ Erythrocyte sedimentation increased in 44.0% of the patients; Antistreptolysin O titers (ASOT) and levels of immunoglobulin A (IgA) increased in 24.1% and 63.7% of the cases, respectively. The levels of immunoglobulin G (IgG), immunoglobulin M (IgM) and complements were normal in most patients. CONCLUSIONS: HSP in children has its own clinical and episodic features.