| Objective: To summarize the general rules of acute urticaria through retrospectively analyzing the data of the 293 patients with urticaria,investigate the correlation of increasing of WBC number with clinical factors in urticaria patients,and the referential meaning of different count of WBC to identifying the pathogenesis,judging the prognosis and choosing the treatment rationally,provide a certain basis for the clinical diagnosis and treatment to urticaria.Methods: Collected the data of the 293 patients of urticaria from department of dermatology and venereology of Yijishan Hospital(from January 2011 to decemb er 2011).By analyzing the general situation,the cause of patients,skin rashes c haracteristics,accompanying symptoms,laboratory tests,treatment and outcome,e tc.,summarized the general law of urticaria.According to the WBC count when patients admitted to hospital,divided the patients into WBC normal group(WB C?10*109)and WBC raised group(WBC>10*109),compared the different of age and sex distribution,inducing factors,skin rashes characteristics,accompa nying symptoms,laboratory tests,treatment and prognosis between the two group s.Used SPSS 20.0 statistical software to analyze the data.Results:(1)The age and sex distribution and length of hospital stay between the two groups had no statistical difference(P=0.083,0.209,0.595 respectively),patients with Infection were younger than the patients without infection.(2)WBC raised group and normal group the proportion of infection were 42.5% and 46.4% respectively,there was no statistical significance(P=0.562>0.05);133 cases of patients with infection and 160 patients without infection average white blood cell count were(13.83±4.87)*10^9/L and(13.10±4.99)*10^9/L respectively,there was no statistically significant difference between the two(P=0.211>0.05).(3)WBC raised group was more inclined to used glucocorticoid before they admitted to hospital after the onset than WBC normal group(P < 0.01).(4)The WBC average of 63 patients had infection who did not use glucocorticoids and 83 patients without infection who had used hormone were(12.80±4.87)*10^9/L and(14.10±4.90)*10^9/L,neutrophil percentage were(81.35±13.71)% and(82.85±9.16)% respectively,there were no statistical significance(P=0.200>0.05;P=0.456>0.05).(5)27 cases(9.2%)of all had some performance of angiodema,14 cases(4.8%)urticaria lasted more than 24 hours,and 178 cases(60.8%)had accompanying systemic symptoms;Whether rash duration more than 24 hours and whether with angioedema has no impact on white blood cell count(P=0.92,0.33>0.05);with more than one systemic symptom with higher white blood cell count than the patients without systemic symptoms(P=0.02<0.05).(6)Whether rash duration more than 24 hours,whether with angioedema and whether have systemic symptom have no relevancy with infection(P=0.146,0.917,0.211>0.05).(7)202 cases had reviewed blood routine examination after 1-2weeks of treats,WBC number had no difference compared to the previous data(P=0.604>0.05),and WBC normal group the number of WBC was increasing after 1-2 weeks treated compared to the before(P=0.005<0.01),while WBC raised group had a opposite expression(P=0.035<0.05).WBC raised group the number of WBC was still above WBC normal group(P=0.019<0.05).(8)202 cases had reviewed blood routine examination after 1-2weeks of treats,the number of thrombocyte was increased compared to the previous(P<0.01),and after treated two group the number of thrombocyte both increased compared to the before(P<0.01,both).WBC normal group the number of thrombocyte was lower than WBC raised group when patients admitted to hospital(P<0.01),but after 1-2 weeks treated there had no difference between the two groups(P=0.074 >0.05).(9)The other laboratory examination indexes:32 cases(13.4%)had increased in ASO(anti-stretolysin O)(ASO>200IU/ml),44 cases(17.3%)ESR(erythrocyte sedimentation rate)increased(males ESR>15mm/h,and females ESR>20mm/h),145 cases(58.5%)had increased in CRP(C-reactive protein)(CRP>10mg/L),85 cases(66.9%)had increased in Ig E(Ig E>100IU/ml),3 cases(2.2%)had increased in C3(C3>1.8g/L)and 5 cases(3.6%)had increased in C4(C4>0.4g/L);182 cases had throat swab culture and 25(13.7%)of them had a positive result,44 cases had detected serum MP-Ab and 7 cases of them had a weakly positive result and 2 cases positive result(total positive rate was 20.5%).There had no different between the two groups about the rates of ASO,ESR,CRP,Ig E,C3 and C4 abnormal,and the positive rate of throat swab culture and serum MP-Ab(P>0.05,all).Conclusion:(1)in patients with acute urticaria peripheral blood leukocyte count increased or not cannot be used as the basis for judging whether there is infection causes alone;(2)there are many reasons for the patients with acute urticaria interleukin increased,especially associated with use of glucocorticoid. |
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