成人腹型过敏性紫癜60例临床特征分析

【目的】探讨成人腹型过敏性紫癜的临床特征和误诊情况。【方法】收集本院2000-2008年诊断的过敏性紫癜病人60例，根据有无消化道症状分为腹型组及非腹型组，对两组病人的临床表现、实验室检查等进行比较，分析成人腹型过敏性紫癜的临床特征及误诊情况。【结果】腹型组与非腹型组过敏性紫癜患者在发病年龄、性别、诱发因素、合并肾脏及关节损害、蛋白尿、血尿等方面均无差异，但腹型过敏性紫癜患者白细胞升高及白蛋白降低更为明显。成人腹型过敏性紫癜患者临床表现为皮疹（100％）、腹痛（100％）、消化道出血（72．9％）、呕吐（32．4％）和腹泻（35．1％）等，成人腹型过敏性紫癜误诊率高（51．4％）。【结论】腹型紫癜患者白细胞升高及白蛋白降低较非腹型组更为明显，消化道症状重，而体征轻微，以腹痛为首发表现者极易误诊．

Clinical Manifestations of Henoch Purpura in Adults

Objective] To discuss the clinical manifestations and misdiagnosis of henoch purpura in adults. Methods] Sixty patients who were treated in our hospital as anaphylactoid purpura from 2000 to December of 2008 were divided into abdominal group and non abdominal group. The clinical manifestations and results of misdiagnosis in the patients were analyzed. Results] There was no statistical difference in onset age, sex, onset inducement, arthralgia and renal involvement, hematuria and proteinuria between two groups. Patients with abdomina.l symptoms had higher white blood cell （WBC）counts and lower albumin levels than those without abdominal symptoms. Main clinical symptoms in patients with abdominal symptoms included skin rash （100 % ）, abdominal pain （ 100 %）, gastrointestinal hemorrhage （ 72. 9 % ）, vomit （ 32. 4 % ） and diarrhea （ 35. 1%）. Patients with henocb purpura were easy to be misdiagnosed（51.4%）. Conclusion] Patients in henoch purpura have significantly higher Wt3C counts and lower albumin levels than anaphylactoid purpura patients without abdominal symptoms. Patients with henoch purpura have serious gastrointestinal symptoms and minor signs, and are easy to be misdiagnosed.