| Objective: To probe the clinical significane of etiological diagnosis, the clinical symptom feature and intercommunication of Henoch-Sch?nlein purpura(HSP). And to analyze the relationship of the clinical symptom and therpy and prognosis. It means to provid information for the clinical diagnosis and therpy of HSP.Methods : 116 patients with HSP were analyzed retrospectively and statistically. These data include the common information, past and present illness history, medical examination, laboratory and auxiliary examination, diagnosis and misdiagnosis, treat and prognosis. All patients were divided into two sets according to American Rheumatism Association(ARA). Teenagers group≤20years and adults group >20years.Results: 1)Morbidity reason, age and gender 62.1% of all patients occurred in December to April. The age of onset was 7~77. there were 77 cases who were under 20 years old. The ratio of male and female was 1.42.2)Etiopathogenisis and inducement 39.7% of the cases had a history of upper respiratory tract infection in the early days. 14 cases(12.1%)were concerned with food (inclinding fish ,shrimp, crab,marine delicacies,egg,honey); 8 cases (7%)were related with medcine(inclinding antibiotics, antipyretic anagesic);Others contained touching weeds,pain and depilatorium. Anthor told the disease was easy to recur in spring. 46 cases were not obvious inducement.3 ) Hypersensitiveness history 20 cases ( 17.2 % ) had hypersensitivity disease.4)Clinicial situation 116 cases(100%)all had purpura and more to see at both lower extremities and haunch; 64 cases had digestive tract symptom and 32 cases whose joints were involved in ; 4 cases and 8 cases who respectively complained lumbago and gross hematuria. 99 cases (85.3%) whose initial symptom were purpura; Stomachache and joint pain could appear before purpura several days, a little before or accompaniment other symptom; But no one whose initial symptom was kidney damage. Others including febricity, acratia, courbature, edema of lower extremity, dizzy, chest distiss, amenorrhoea, scrotum pain.Teenages group(≤20years)was more easy to generate stomachache than adults group(>20years)(P<0.01).Those who had stomachache were more easy to affiliate Nephritis of HSP (HSPN) at the same time than those not(P<0.01 ), and whether or not to take place nephritis was concerned with stomachache(OR=10.7).Otherwise teenages had more joint pain than adults(P<0.05).5 ) Laboratory and auxiliary examination Three common practice,APTT,blood biochemistry All patiens platelet count >100×109/L,52 cases raised up white blood cell or ratio of neutrophil ,32 persons were anaemia ; 52 cases (44.8%)had urine abnormality(for haematuria and albuminuria); 26 cases (22.4%)were masccline of FOB. 32 cases (27.6%)degraded ALB and 14 cases (12.1%)steped up ALT. 11 cases (9.5%)showed a little extent of APTT. Incidence rate and severity degree of kindey damage in adult group was higher than Teenages group(P<0.01).Virus detection was done in 12 cases and fond 4 patiens HBV+, 2 patiens EBV+ and 1 patien CMV+ . There were 10 patien who were found masccline of HP infection by gastroscopy. There were 3 example seroperitoneum and 1 example intussusception by B-ultrasound in 8 patiens.6)Diagnosis and misdiagnosis Simple type 9 examples, abdomen type 13 examples, jiont type 4 examples, kindey type 11 examples and mixed type 79 examples.20 cases(17.2%) were misdiagnosised. It was misdiagnosised as disease of digestive system(15 cases)and 2 cases were done appendectomy by misdiagnosis.7)Turnover 106 cases were recovery or symptom disappearance. 8 cases had refractoriness haematuria, albuminuria while to leave hospital. Recurrence rate was 38% in this group. The average hospital days of HSPN and un-HSPN were 15.06±13.23 days and 10.26±5.93 days.Conclusion: HSP can happen in any age but teenager is easier to be seen than adult, and most of those in winter or spring.Male patients are more than female. Children are easy to happen purpura, stomachache and arthralgia. But adult have more nephritis as well more severity. Misdiagnosis shoud be wared when stomachache is first symptome in clinic. Because there are shortage of specific laboratory examination, common practides must been done to initially differentiate from other diseases. Those who urine-Rt is negative should recheck. Cause of the disease should be actively reliefed and especially care for chronic tonsillitis and eurodonticus. The stomachache patients should early exert hormone fherapy . the patient of alimentary tract hemorrhage should unite anti-Hp and cortex hormone. pper respiratory infection and therapy of HSPN . the adult and female patients should prescript cortex hormone.
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