成人腹型过敏性紫癜的临床分析

目的研究成人腹型过敏性紫癜的临床、内镜特点及误诊原因,以提高对此病认识。方法对我院1996年1月～2004年12月住院的64例腹型过敏性紫癜患者进行回顾性分析,其中20例行胃镜检查,14例行结肠镜检查。结果临床表现的特点是以腹痛、消化道出血、腹泻为主,分别为89.8%、46.5%和12.8%。内镜下胃肠道黏膜呈不同程度的充血水肿,广泛多发的充血、水肿、出血点、糜烂、多发溃疡等,上消化道以十二指肠降段最严重,下消化道以末段回肠最严重。12例被误诊,分别误诊为消化性溃疡、急性胃黏膜病变、急性阑尾炎、肠梗阻、急性出血坏死性小肠炎、急性细菌性痢疾等。结论成人腹型过敏性紫癜临床表现复杂,易造成误诊,结合该病的临床及内镜特点,可早期诊断,及时治疗。

Clinical analysis of adult henoch purpura

Objective To investigate the clinical and endoscopic features of adult henoch purpura and to analyze the reasons of misdiagnosis so as to get better understanding of the disease . Methods To Retrospectively analyze the clinical data of the sixty-four cases who hospitalized from Jan.1996 to Dec. 2004. Gastroendoscopy was taken in 20 cases; colonoscopy was taken in 14 cases. Results The clinical manifestations of henoch purpura were abdominal pain, alimentary tract hemorrhage and diarrhoea.The were respective 89.8%?46.5% and 12.8%.Endoscopy demonstrated the mucosal injuries including congestion, edema, petechia, anabrosis and multiple ulcers .The most serious position involved was the descending portion of duodenum and the terminal ileum. 12 cases were misdiagnosed, such as peptic ulcer, acute hemorrhagic gastritis, acute appendicitis, bowel obstruction, acute hemorrhagic necrotic enteritis and acute bacillary dysentery. Conclusions The clinical manifestation of adult henoch purpura is various, and the disease was misdiagnosed easily .To combine the clinical and endoscopic features, the disease could be early diagnosed and treated in time.