儿童过敏性紫癜临床特征分析(附184例报道)

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 ;6 7.4 %患儿于秋冬季节发病 ;6 2 .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 (10 0 % )、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 6 0 .9%和 4 4 .6 %。紫癜性肾炎发生率为 5 2 .2 % ,临床上主要表现为血尿和 (或 )蛋白尿 (6 8.8% ) ,病理改变主要为Ⅰ～Ⅲ级 (85 .2 % )。③ 4 4 .0 %病人血沉增快 ,2 4 .1%ASO增高 ;6 3.7%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

Clinical Features of Henoch-Schnlein Purpura in Children: a Report of 184 Cases

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.