| Objective:To research the relationship between the clinical symptoms of Henoch-Schonlein Purpura(HSP)and the related laboratory markers,and to explore the predictive value of laboratory markers in HSP related gastrointestinal bleeding of children.As soon as possible to identify the children who may have adverse complications,so that medical personnel can find and intervention early to reduce the incidence of gastrointestinal bleeding in HSP.Method:Collected the first diagnosis and hospitalization of HSP in children from May 2014 to May 2016 in the first hospital in Lanzhou University,148 patients were enrolled in HSP group,who were in the acute phase,without glucocorticoid and immunosuppressive therapy,excluded other infections.At the same time,77 patients of children were collected as the control group,who were hospitalized for abdominal pain and without any organic disease after examination.Both groups were collected blood on the day of admission,and tested blood routine,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and so on as usual.To collect and record the sex,age,length of hospital stay,clinical manifestations,clinical signs and the use of hormones of the two groups,and to extract white blood cell count(WBC),lymphocyte absolute value,neutrophil absolute value,hemoglobin(Hb),platelet count(PLT),mean platelet volume(MPV),CRP and ESR,to figure out neutrophils to lymphocytes ratio(NLR).Results:(1)Among the 148 children of HSP,81 cases were male and 67 cases were female,male to female ratio of 1.2: 1.The age ranged from 2 to 16 years with the average age of(7.7 ± 2.8)years.The hospital day ranged from 2 to 27 days with the average length of hospital stay of 6.5(5~9)days,maximum cases with onset in winter and spring.In the acute phase of these children,the skin purpura for the first is 143 cases,with abdominal pain in the first is 3 cases,starting with joint pain is 2 cases;gastrointestinal bleeding in HSP were 39 cases,accounting for 26.4%,of which the occurrence of intussusception,1 case of surgery.After diagnosis,the uses of hormones were 111 people,accounting for 75% of 148 children of HSP.(2)WBC,absolute neutrophil count,PLT,and NLR levels were significantly higher in HSP group compared with the control group,absolute lymphocyte count was significantly lower in HSP group(P<0.05).(3)WBC,absolute neutrophil count,NLR,and CRP levels were significantly higher in HSP patients with GI bleeding when compared to patients without gastrointestinal bleeding,while absolute lymphocyte count was significantly lower in patients with gastrointestinal bleeding than the patients without gastrointestinal bleeding(P<0.05).(4)The total clinical scores of HSP patients were more strongly correlated with WBC(r=0.344,P<0.001),absolute neutrophil count(r=0.405,P<0.001),NLR(r=0.364,P<0.001),PLT(r=0.185,P=0.024),and CRP(r=0.258,P=0.002).(5)CRP and NLR were the only two indicators associated with gastrointestinal bleeding in HSP in logistic regression analysis.(6)The area under the ROC curve analysis indicated that CRP could be a more efficient potential predictor of gastrointestinal bleeding in HSP when compared to NLR.Conclusion:This study suggested that CRP>7.25mg/L jointly with NLR>3.43 might predict gastrointestinal bleeding in HSP better,and should be taken attention in clinical. |
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