Clinical Analysis Of 100 Cases Of Abdominal Type Henoch Schonlein Purpura In Children

Objective:Allergic purpura(Henoch-Schonlein purpura,HSP)is mediated by immune complex.It is a systemic capillary allergic and hemorrhagic disease,Often occurs in preschool and school-age children.The abdominal type of HSP is given priority to visceral capillaries and small arteries,It is a type of HSP.The typical clinical manifestations are abdominal cramps,vomiting and bleeding from the digestive tract.The merger of gastrointestinal bleeding patients accounted for about 18% ~ 52%.,Up to now,there is no gold standard about abdominal type HSP’s diagnostic.Especially in the gastrointestinal tract symptom onset of abdominal type for children with HSP.Because there is no typicalclinical manifestations of rash,early diagnosis is difficult,It’s easy to mistake the diagnosis and treatment.thus increased the risk of gastrointestinal bleeding and other complications,at the same time also increased the cost of treatment and the case of fatality rate.It is reported the sonographic of children abdominal type of HSP is specific.It not only can find the early detection of bowel lesions,but also no radiation,and good repeatability.Therefore,this article through to analysis the clinical,abdominal ultrasound and laboratory examination indexes of the 100 cases of children abdominal HSP,For the early diagnosis of children with HSP,abdominal condition judgment,estimating prognosis,danger forecast and provide reference for drug treatment.Methods:1 the object of study: the total of the topic case group is 100,the total of boy is 60,and girl is 40,its ages from 3 to 13 years old,the average age is 7.7±6.5 years old.They all comes from the children hospital’s Kidney and immunity Departments of hebei province.They are diagnosised abdominal type HSP in November 2014 to October 2015.2 Testing index and experiment method: In two days all the childrens should do the routine urine test,occult blood,CRP,ESR,IgA levels,liver and kidney function,electrocardiogram,blood and bowel ultrasound.Intestinal ultrasound mainly observe intestinal wall thickness,peritoneal effusion,mesenteric lymph nodes.Analysis of the indicators in the digestive tract hemorrhage group and the difference between the digestive tract hemorrhage group.3 statistical methods: SPSS21.0 software was applied to the data for statistical analysis.The count data to form than(%)is described.Comparison between groups using four table chi-square test,P<0.05 for the difference is statistically significant.Results: The group of 100 cases of abdominal type HSP have abnormal pain symptoms,among them there are 14 cases whose rash occurs before the gastrointestinal symptoms.54 cases have gastrointestinal bleeding,24 cases have vomiting,27 cases accompanied by joint swelling.All the children with line of blood in the urine routine,occult blood,serum IgA,c-reactive protein and blood sedimentation,liver and kidney function,electrocardiogram and intestinal ultrasound.Blood leucocyte heightened in 26 cases;platelet Increased in 31 cases;eosinophils increased in 2 cases;12 cases of abnormal urine test;c-reactive protein increased in 19 cases;Blood sedimentation speeded up in 36 cases;serum levels of IgA increased in 46 cases;All the children have normal liver and kidney function;Sinus bradycardia in 17 cases.There are 49 cases whose bowel wall ultrasonic examination shows different degree of thickening segmental or generalized;Lesions located in the small intestine,thickening of the range from 3 to 11mm;Mesenteric lymph node enlarged 29 cases,20 cases have abdominal cavity effusion.By allergy and symptomatic treatment 3~7d,children with abdominal pain eased significantly,49 cases were performed ultrasound review,3 cases of bowel wall thickening(> 7 mm)back to 4~6mm,intestinal wall blood flow signals from the previous decreased significantly;46 cases of bowel wall thickening(3 ~ 7 mm)basic returned to normal.SPSS21.0 application software of the data for statistical analysis.Abdominal type of HSP in gastrointestinal bleeding and no gastrointestinal bleeding group contrast between sinus bradycardia statistical results was statistically significant(P<0.05);The change of intestinal wall thickness was statistically significant(P<0.05);Vomiting P=0.625,joint symptoms P=0.849,there is no statistical significance;White blood cells,platelets,ESR,c-reactive protein and the increasing of serum IgA have no statistically significant.Conclusion:This research data shows that:1 Abdominal type allergic purpura in children occurs in preschool and school-age children.Most children accompanied by abdominal pain symptoms for paroxysmal severe abdominal pain,some children may be accompanied by vomiting and bloody.2 The incidence rate of sinus bradycardia in the group with gastrointestinal bleeding is obviously higher than the group with no gastrointestinal bleeding.We should be attention in the process of clinical treatment,give them nutritional myocardial treatment earlier.3 The thickening of intestinal wall may be an important predictor of gastrointestinal bleeding,Children with abdominal type allergic purpura should be early lined of abdominal ultrasound.If the patient’s bowel wall thickened,they Should be observed closely.In order to prevent the gastrointestinal bleeding,we should strengthen anti-inflammation and aggressive treatment measures such as protection of gastrointestinal mucosa,For the preschool and school-age children with simple clinical performance without cause of abdominal pain,They should be earlier lined of abdominal ultrasound too,in combination with other test indicators,to be diagnosised earlier.4 the symptom such as vomiting,joints,and the laboratory examination indexes have no specificity,they have no specific contaction with the incidence of gastrointestinal bleeding or not.Combined with the clinical manifestation,it has certain guiding significance for the diagnosis and treatment of the disease.