| Object:To study the clinical characteristics and prognosis of Henoch-Schonlein purpura,makebetter understangding of the disease, expect to help to better guide clinical treatment andimprove prognosis.Methods:This was a retrospective study.Our study object were children discharged with adiagnosis of HSP from Pediatric department of the first hospital of Jilin Uniuersity betweenSep2013and Aug2014. Cinical data and follow-up data including gender, age, seasonaloccurrence, predisposing,factors, clinical manifestation,laboratoryexamination,treatment,prognosis were collected.Using SPSS18.0software for all relevant datafor statistical analysis.Result:1.There were185male and138female in323HSP.The ratio of male and female was1.34:1.The age range was3to14years,and peak age was from4to9,accounting for68.7%.The outbreak of HSP occurred mainly in spring、autumn and winter.Before the onset ofHSP,there were177cases who had an infection,172cases（53.2%）was respiratory tractinfection.And31cases (9.6%) who eat seafood, eggs, soy products, snack foods,1case (0.3%)who had the suspected drug allergy,114cases (49.1%) who did not track the likely significantincentives.2.323cases of children with HSP were successively appeared skin purpura, iandnvolving the parts to the most common were double lower limbs(313cases,96.9%).205cases(63.4%) of the HSP appeared abdominal pain,67cases (20.7%) appeared the digestive tracthemorrhage,4cases (1.2%) appeared acute pancreatitis,2cases appeared intussusception(0.6%),2cases appeared incomplete ileus (0.6%),1case (0.3%) appeared intestinal necrosisand perforation, of which3cases (0.9%) underwent surgical operation treatment.Is startingsymptoms of children with abdominal pain,4cases (1.2%) in the diagnosis of appendicitis,appendix removed.There were62cases (19.2%) with kidney damage, abnormal urine routineof50cases (80.6%) appeared in the course of a month,the clinical manifestations of12 patients with isolated hematuria (19.3%), isolation proteinuria in5cases (8.0%, among them1case for kidney disease levels of proteinuria), hematuria and proteinuria in42cases (67.7%,including10cases for kidney disease levels of proteinuria), nephrotic syndrome in3cases(4.8%).Joints involved appeared152cases (47%), mostly involving large joints.3.In the laboratory examination，WBC was increased in180cases(55.7%)，PLT wasincreased in177cases（54.8%）,CRP elevated in179cases (55.4%), blood IgA increased20cases (6%), blood IgG decreased in15cases (4.6%), ANCA positive in4cases (1.2%),ANA positive in3patients (0.9%), blood C3reduce in2cases (0.6%).281cases of detectionantibody of pneumonia mycoplasma and chlamydia, mycoplasma antibody were positive in153cases (54.4%), chlamydia antibody were positive in73cases (26%).ASO was increasedin34cases (11.3%) of301cases of detection.Another156regular checks on the fiveepstein-barr virus,5cases (3.2%) of the IgM antibody were positive;In7cases withintermittent abdominal pain, not except gastritis did C13breath test,5cases were positive.3cases which exist contact TB, did TB test spots,1case was positive.4.191cases (59.1%) in the course of the acute phase of the application of glucocorticoid,171cases (89.5%) is the severe gastrointestinal symptoms.5.Abdominal pain single factor analysis: the WBC,PLT, CRP, NE%rise,age≧10y is a risk factor for abdominal pain, P <0.05;Multiple factors analysis: the WBC,CRP, NE%increase are independent risk factors for abdominal pain, P <0.05.Single factoranalysis of risk factors for renal involvement: age7years old, skin rashes repeated3times ormore in3months, severe abdominal pain, gastrointestinal bleeding is the risk factor of renalinvolvement, P <0.05;Multiple factors analysis: age7years old, skin rashes repeated3times or more in3month are high risk factors of the HSP kidney involvement, P <0.05.6.7to18months follow-up period, skin rash recurrence repeatedly in194cases (60%);3cases (0.9%) were susceptible to respiratory tract infection than before;3cases (0.9%) weresusceptible to skin allergy compared with the previous.In62cases of children with HSPN,theroutine urine of51cases returned to normal, while11cases presented with persistentmicroscopic haematuria, or a small amount of proteinuria.7cases of abdominal purpuraappeared intermittent abdominal pain, which can relieve itself.Conclusion:1.Before the onset of HSP, respiratory tract infection are commonsymptoms.Mycoplasma pneumoniae infection may be closely related.2.It should pay attention to the digestive tract symptoms in the acute stage of HSP.The WBC, CRP, NE%increase are independent risk factors for abdominal pain.3.age7years old, skin rashes repeated3times or more in3month are high risk factorsof the HSP kidney involvement.4. HSP long-term prognosis is good. A small number of children may occur functionalgastrointestinal disease or longer immune dysfunction. |
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