成人腹型过敏性紫癜31例临床分析

目的 探讨成人过敏性紫癜腹型的临床特点,以提高早期诊断与治疗水平。方法 回顾性分析邯郸市第一医院血液内科2007年3月至2010年6月诊治的61例成人过敏性紫癜中具有腹痛表现患者(31例)的临床资料,并与同期非腹型紫癜患者(30例)进行对比分析。结果 31例腹型过敏性紫癜患者具有腹痛症状,其中脐周痛占48.4％(15/31),全腹痛占38.7％(12/31),下腹痛占12.9％(4/31),恶心、呕吐占19.4％ (6/31),便隐血试验阳性占45.1％(14/31)。其中13例行胃、肠镜检查显示十二指肠及同肠末端内见黏膜散在片状出血点,糜烂,浅表溃疡等损害。有腹痛症状和无腹痛症状者比较,2组在年龄、性别、过敏史、前期感染史方面差异均无统计学意义(P均＞0.05)。腹痛组混合型明显多于无腹痛组(24例与6例),差异具有统计学意义(x2= 16.725,P＜0.01)。结论 成人腹型过敏性紫癜以中、青年为主,所以对于年轻急腹症患者应高度警惕腹型过敏性紫癜;有腹痛症状的过敏性紫癜患者以混合型居多,且胃、肠镜检查表现具有一定的特征性,能为早期诊断提供有价值的依据。

The clinical characteristics of adult abdominal type Henoch Scholein purpura

Objective To summarize the clinical features of adult patients with abdominal type Henoch Scholein Purpura(HSP) to improve the early diagnosis and therapeutic outcome of HSP.Methods The clinical features of 31 adult patients with abdominal type HSP from the Hematology department of Handan First Hospital between March 2007 to June 2010 were retrospectively reviewed and compared with that of 30 adult patients with non-abdominal type HSP.Results All the 31 patients had abdominal pain.Of those patients,48.4％ had periumbilical colicky pain, 38.7％ had whole abdominal pain and 12.9％ had lower abdominal pain.The other clinical manifestations included nausea/vomiting(19.4％) ,positive feces occult blood test(45.1％) .EGD and Colonoscopy of 13 patients showed mucosal congestion, red macda, erosion and ulceration mainly in the descending duodenum, distal ileum and rectosigmoid.There was no difference in age, gender, allergic history and predisposing infection between those with abdominal pain and without.The patients with abdominal pain had more cases of mixed-type HSP than those without and the difference was significant (P ＜ 0.01) .Conclusion Patients with abdominal-type of HSP are mainly young adults.So we must be more alert to abdominal-type of HSP when facing young patients with abdominal emergency.Abdominal-pain-manifesting HSP patients are mostly mixed-type cases.Gastrointestinal endoscopy is specific and might provide valuable clues for early diagnosis.