The Dermatology Clinical Analysis Of Henoch-sch(?)nlein Purpura In 459 Cases

Objective:To collect and analyze the clinical characteristics of Henoch-Sch(?)nlein purpura(HSP)patients who visited the Second Affiliated Hospital of Kunming Medical University.Analysis of patients are focused on the clinical features,in order to examine its risk factors.This study aims at improving the diagnosis and treatment of Henoch-Sch(?)nlein purpura.Methods:Inputting 459 hospitalized HSP patients' data of the Second Affiliatd Hospital of Kunming Medical University from 2005?2015 were systematically reviewed by using statistical software SPSS 21.0 and inviding them into the juvenile group(<18 years old),the adult group(?18 years old)or organ involvement group,organs intact group.Two groups were compared between the differences in clinical manifestation,laboratory examination results.And by Logistic regression to analysis the joints of HSP,the digestive tract,and kidney involvement of related risk factors.Results:1.The minor group and the adult group have different in disease onset time,statistical difference(P<0.05),in January the minor group has more patients than the adult group,in August the two groups are on the contrary(P<0.05).The two groups have no statistically significant difference when compare with sex,age and season(P>0.05).2.The triggers are different from the juvenile group and the adult group,statistical difference(P<0.05),the infection factor of juvenile group,food factor in the adult group,a significant difference between the two groups(P<0.05).3.The starting symptoms are different from the juvenile group and the adult group,statistical difference(P<0.05).The adult group has more patients than the juvenile group when compared with the rash,and on the contrary,when compared with a rash onset of the symptoms of the joints and all appear at the same time,a significant difference between the two groups(P<0.05).4.Compared the clinical classification,the juvenile group and the adult group have statistically significant(P<0.05),in which one type of renal purpura morbidity than the minor group and mixed type(joint + abdomen)minor group has more patients than the adult group.The adult group is more likely to appear kidney injury,the minor group is more likely to appear the digestive tract involvement,the two groups remained statistically significant(P<0.05).5.Compared the laboratory examination between the minor group and the adult group:juvenile patients were higher than the adult patients when compared with the lymphocytes,monocytes and platelet,IgM,APTT and antithrombin III values,(P<0.05);And hemoglobin count,neutrophil/lymphocyte ratio,IgG,IgA,complement C4,Fib count were lower than the adult group(P<0.05)Juvenile patients were likely to high blood platelet,ASO,low total cholesterol,and creatinine.Adult patients were likely to high red blood cells,elevated triglycerides,blood sedimentation,urine protein,urine occult blood positive,the minor groups and the adult group had statistically significant difference between the two groups(P<0.05);And urine protein(+-),(3 +),urine occult blood(2 +),(3 +)also have statistically significant difference between the two groups(P<0.05).6.Allergen test suggest that minors are more likely allergic to high-protein foods,while adults of aquatic products,cattle,sheep and chicken meat food allergy is seen;Joint involvement is allergic to cattle,sheep and chicken meat more than no involvement,statistical difference(P<0.05).7.The patients who have kidney suffers are more likely to appear anti cardiolipin antibody,resisting RNP antibody positive/SM,compared with the less kidney involvement group,a significant difference between the two groups(P<0.05).8.The relevant section,the digestive tract,and renal involvement group have high count of white blood cells,lymphocytes,compared with its no related involvement group,differences were statistically significant(P<0.05).9.The digestive tract affected and kidney suffers had statistical significance(P<0.05)than less suffers,when compared with IgA value,neutrophils/lymphocyte ratio difference.And the digestive tract affected compared with less digestive tract involvement group,the IgA value is low,the kidney suffers compared with less kidney involvement group the IgA value is high;The digestive tract,kidney involvement group compared with the less suffers the neutrophils/lymphocyte is high accordingly.10.Logistic regression analysis showed that infection(OR = 3.367)is the important risk factor of induced joints involved;Age<18 years old(OR = 1.748)is the important risk factor for the development of the digestive tract involvement;Elevated triglycerides(OR = 6.257),RBC>5 x 109/L(OR = 2.589)are the important risk factors for renal involvement.Conclusions:1.The incidence seasons of Allergic purpura are in winter and spring,the primary factor to induce HSP is infection,pathogenesis are more likely to associated with upper respiratory tract infection,and infection is the important risk factor of induced joints involved.2.Age<18 years old is the important risk factor for the development of the digestive tract involvement.3.Elevated triglycerides,RBC are the important risk factors for renal involvement.4.Doctors should attach great importance to the multiple system clinical damage of the HSP patients,such as skin,joints,the digestive tract,kidney,etc.Particularly give attention to the minor patients with the digestive tract involvement and adult patients with renal involvement.