Clinical Analysis Of351Cases Of Hospitalized Children With Henoch-scholein Purpura

Objective: Allergic purpura is also known as Henoch-Schonlein purpura.It is a not thrombocytopenic hemorrhagic disease which is common in chidrencaused by a variety of reasons. HSP is microvascular of allergic disease. Heb-e rde in1801given a detailed description of this disease. But originally byWillan in1808put forward the disease as an independent disease concept.Since Scholein in1837found that most of patients had the symptoms of upperrespiratory tract infection before the onset of the disease. The Henochprofessor spent his whole life in studing this disease. And in1895herevealded the disease can lead to severe renal injury. By later generations forthe continual research, had made great achievements.The disease occurs in school-age children, more boys than girls. Mosthappende in autumn-winter season, were often self-limiting. The causes werestill unclear, but generally believed to be related to infections, drugs, specialfood and so on. The research shows that many pathogens infection plays animportant role in the disease[1]. The pathogenesis wsa still unclear. Studies hadshown that infection, food and drug allergy in the role of inducement triggerdesuch as sensitive body, which mainly caused the body’s IgA mediatinghumoral immune disorders. Including cytokines, T lymphocyte dysfunctionand inflammatory mediators were involved in the course of HSP[2]. Studieshad shown that the genetic susceptibility also play an important role in thepathogenesis[3].According to its corresponding target organ damage, producecorresponding clinical manifestations. And according to its clinicalmanifestations could be divided into pure form, joints form, abdominalis formand kidney form. The skin typical purpura often performed as originalsymptom. It was easily misdiagnosed when abdomen and join symptoms were the first symtom. HSP was self-limited disease, with favourable prognosis. Butthe renal injury of the HSP could affect children’s quality and prognosis. Themost cases with renal injury had good prognosis. But15%cases hadcontinuative renal injury, about8%cases process to kidney failure[4].HSP had nonspecific laboratory examination. Some cases could performthe increase of WBC and PLT. Because the HSP was humoral immunitydisorder mediated by IgA. So some cases could perform the IgA increased inperipheral blood.Through analyzed the onset of HSP, aim to study the clinical charact-eristics,pathogenesis and prognosis of children Henoch-Scholein purpura.Methods:1The reseach object: Selected the351cases of children with untreatedHSP as the object,which were receive treatment in the Second Hospital ofHeibei Medical University in January2012to December2013. The351caseswere all met the “Zhu Fu Tang practical pediatrics” diagnostic of allergicpurpura:①Tanibility purpura;②The onset age <20years old;③Acute ab-dominal pain;④Tissue biopsy showed the neutrophils invasion around thelittle veins and arteries. The cases should conform to article2or above. Thediagnostic criteria of purpura nephritis were that: haematuria and (or)proteinuria presenting during the first6months course. Cases met the criteriacan be diagnosed.2Research methods:351cases with Henoch-Scholein purpura weredivided into severe groups according to age, gender, good reason, incentives,first symptom, main symptom, laboratory examination, and descriptivestatistical and analysis.3Detection method:3.1The detection of WBC and PLT: Venous blood made by professionalsdetected for routine blood test in the Second Hospital of Heibei MedicalUniversity. Through the resistance type of blood cell analysis, detected theresistor changes which caused by the through of blood cell. After theamplified and screening of the pules signals, converted the pulse numbers to cell numbers. The pulse height was proportional to the cell volume. Detectionmethod: Took the venous blood1ml. Injacted to anticoagulant tube,thoroughly incorporated. Then sucked the blood by machine. Inspected andprinted reports.3.2Blood IgA detection: By double optical path immune turbidty method,got5ml blood in fasting state. Placed at room temperature2h, then centrifuges15min. Go below80℃refrigerator used to serum separation. Used equalamount of phosphate dilution. Then chromatography, Washed theuncombination part by the buffer of175mmol/L Tris-HCl. Combination parteluted by the buffer of175mmol/L Tris-HCl contains melibiose of0.1mol/L.concentrated by polyethylene glycol, then dialysis by distilled water. Detectedthe concentration of IgA in the samples.4Statistical analysis: using SPSS Statistics13.0software for data statis-tics. Count data comparison between group using squared inspection. SelectP<0.05for statistical significance.Results:1General information: This research contained351cases, which had214male and137female, and man to women was1.56:1. Aged from2years8mouths to14years. The average age was8.6±2.93. The onset and proportionof spring, summer, autumn and winter respectively performed87cases,accounting for24.79%;54cases，accounting for15.38%；99cases，accountingfor28.2%；111cases，accounting for31.62%.2Infection was the primary cause, with184cases, accounting for52.4%.Food allergy had62cases, accounting for17.7%.10cases were causedallergic to pollen, dust and other decoration, accounting for2.8%.3casesallergic to vaccine, accounting for0.85%.1cases allergic to drug, accountingfor0.28%.91cases had no obvious cause, accounting for25.9%.3Pure skin purpura was the most common original symptoms, which had118cases, accounting for33.7%. There were32cases whose primarysymptom was abdominal symptoms, accounting for9.1%. There were106cases whose primary symptom was skin purpura with abdominal symptoms, accounting for30.2%. There were41cases whose primary symptom was skinpurpura with arthritis symptoms, accounting for11.7%. There were54caseswhose primary symptom was skin purpura with abdominal symptoms andarthritis symptoms, accounting for15.4%.4Main symptom: All351cases were successively appeared typicalpurpura. There were183cases whose main symptom was abdominalsymptoms.99cases’ main symptom was arthritis symptoms.106casesappeared renal injury. Gender on the incidence of kidney had no statisticalsignificance. More than10years old children were at risk of renal injury.And4cases(1.14%) performed encephalitis symptoms, such as headache and poorspirit.2cases(5.74%) had vaginal hydrocele.1cases(2.49%) had pancreatitis.5Laboratory test showed127cases’ elevation of WBC, accounting for36.2%.79cases’ PLT increased, accounting for22.51%. Blood IgA rose in115cases, accounting for36.51%. The increase of WBC and blood IgA hadno statistical significance to the renal injury. Increased PLT cases were at therisk of renal injury.6The351cases were all cured, and prognosis was good, had no death.Conclusion:1The main targets of HSP were school-age children, boys than girls, andoccurred in autumn winter. Many had precursor infections. Skin purpura wascommon original symptom. Clinical manifestations could perform skin type,abdominal type, arthritis type and kidney type. There was no specificlaboratory examination.2Gender on the incidence of kidney had no statistical significance. Morethan10years old children were at risk of renal injury. WBC increased or nothad no significant to the renal injury. Increased PLT cases were at the risk ofrenal injury. Blood IgA could increase in HSP, but had no significant to the renal injury.3HSP had better prognosis.