儿童腹型过敏性紫癜的高危因素

目的：探索儿童腹型过敏性紫癜（HSP）的高危因素,为早期诊治提供依据。方法：收集2011年1月至2018年12月在金华市第五医院住院治疗的HSP患儿98例,其中腹型HSP患儿50例,皮肤型HSP患儿48例,比较2组患儿的临床特点和实验室指标。采用logistic回归分析筛选影响儿童腹型HSP的高危因素。结果：腹型HSP患儿出现上呼吸道感染诱因比例显著高于皮肤型HSP患儿,差异均有统计学意义（P＜0.05）。腹型HSP患儿的血白细胞计数、中性粒细胞计数、C-反应蛋白、D-二聚体均高于皮肤型HSP患儿,差异有统计学意义（P＜0.05）;而2组间性别、年龄、发病季节、住院时间以及血红蛋白、血小板计数、血钾、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血白蛋白、血沉、补体C3、C4、IgA、凝血酶原时间、活化部分促凝血酶原激酶时间差异均无统计学意义（P＞0.05）。Logistic回归分析显示上呼吸道感染（OR=3.54,95%CI=1.29～9.75,P=0.014）及D-二聚体增高（OR=4.23,95%CI=1.28～13.96,P=0.018）是儿童腹型HSP发生的独立高危因素。结论：对存在上呼吸道感染以及D-二聚体偏高等高危因素的HSP患儿应予早期干预,积极正确处理,以期防止并发症的发生。

Risk factors of abdominal Henoch-Schönlein purpura in children

Objective: To investigate the risk factors of children with abdominal Henoch-Schönlein purpura (HSP) and to provide the predictors for early clinical diagnosis and treatment. Methods: Ninety-eight children with HSP from the Fifth Hospital of Jinhua during January 2011 and December 2018 were collected, which included 50 abdominal HSP and 48 skin-type HSP. The clinical characteristics and laboratory indicators of those children between two groups were compared. The risk factors of HSP in children were analyzed by logistic regression analysis. Results: The incidence of upper respiratory tract infection in children with abdominal HSP was significantly higher than that in children with skin HSP (P<0.05). The laboratory indicators of white blood cell count, neutrophil count, C-reactive protein, D-dimer in children with abdominal HSP were significantly higher than those of skin-type HSP (P<0.05). There were no significant differences between the two groups (P>0.05) in other indicators such as gender, age, season of onset, hospitalization days, hemoglobin, platelet count, serum potassium, alanine aminotransferase, aspartate aminotransferase, serum albumin, ESR, complement C3, C4, IgA, prothrombin time and activated partial prothrombin kinase time were not significantly different between the two groups (P>0.05). Logistic regression analysis showed that upper respiratory tract infection (OR=3.54, 95%CI=1.29-9.75, P=0.014) and high D-dimer (OR=4.23, 95%CI=1.28-13.96, P=0.018) were independent risk factors for HSP in children. Conclusion: Children of HSP with risk factors such as upper respiratory tract infection and high D-dimer should be intervened early and treated properly to prevent complications.