Analysis Of Clinical Risk Factors Of Renal Damage In Children With Henoch-schonlein Purpura

Objective:Henoch Schonlein Purpura(HSP)is one of the common diseases of children,as a systemic disease whose main pathological changes is small vasculitis.Its main clinical symptoms is non-thrombocytopenic purpura,arthritis,joint pain,stomachache,gastrointestinal bleeding,hematuria and proteinuria.When the kidneys are involved,namely Henoch-Schonlein Purpura Nephritis(HSPN),its early attack is very hidden,the routine laboratory results are often without exception.The kidney pathology examination is the golden criterion for the diagnosis of HSPN,as an invasive examination,renal biopsy has a great risk and trauma,and it is hard to accepted by the patients and their families,which can lead to delayed treatment and make things worse,or even progress to chronic renal insufficiency.Therefore,exploring the clinical risk factors of children allergic purpura kidney damage is of great clinical significance for early intervention in the occurrence and development of purpura nephritis.Method:Finding out the hot and controversial clinical risk factors of children allergic purpura kidney damage through reading the relevant literature in recent years.The clinical data of 130 patients with HSP were collected from the pediatric hospitalization of the first affiliated hospital of nanchang university from January2015 to June 2017,including gender,age,whether to have respiratory infection,whether there is pneumonia mycoplasma infection recently,the number of times a rash is repeated,the duration of the rash,whether accompanied with joint swelling or abdominal pain,whether to have gastrointestinal bleeding,white blood cell count,platelet count,FIB,routine urine,24-hour urinary protein quantification,the time of kidney involvement.All of the patients were followed up for 6 months.According to the diagnostic criteria of children HSPN,the selected HSP children were divided into90 cases of non-renal injury group and 40 cases of renal injury group.Using statistical means of single factor analysis,each risk factor was analyzed between thetwo groups to search statistically significant risk factors,and then multifactor nonconditional Logistic regression analysis was performed.Results:1.The general condition: 130 children with HSP were enrolled in this study,there are 77 male cases(59.2%),53 female cases(40.8%)and the sex ratio is1.45:1.0.The youngest child was 2 years old,the eldest child was 14 years old,and the average age of onset is 7.78 + 2.89.Among the 130 children with HSP,40 cases of renal injury occurred,26 cases(65.0%)of male and 14 cases(35.0%)of female,the incidence of renal injury was 30.77%,There were 36 cases of kidney injury in the first month of onset,90% of the children with renal injury.2.Clinical features: All of the 130 HSP children had purpura(100%).There were 107 cases(82.3%)of the patients with the involvement of the joint,75 cases with abdominal pain(57.7%)and 21 cases with gastrointestinal bleeding(16.1%).3.A single factor analysis was carried out on the risk factors of renal injury of children with HSP,chi-square test for counting data,and the results show that aged 6or higher,the rash lasts for more than 2 weeks and gastrointestinal bleeding in the differences between the two groups have statistical significance(P < 0.05).While there were no statistical significance between the two groups in gender,respiratory infection,pneumonia mycoplasma infection recently(IgM+),the rash repeated more than 3 times,abdominal pain and joint swelling(P>0.05).The measurement data was tested by t test,and the results showed that white blood cell count,platelet count in the differences between the two groups have statistical significance(P<0.05).There were no statistical significance between the two groups in FIB level(P>0.05).4.Multifactor non-conditional Logistic regression analysis: the analysis of multifactor non-conditional logistic regression was carried out to analyze the risk factors with statistically significant difference between the two groups,and the result shows: aged 6 or higher,the rash lasts for more than 2 weeks,gastrointestinal bleeding and Increased platelet count are the independent clinical risk factors for children allergic purpura and renal injury.Conclusion:1.The incidence of secondary renal damage in children with HSP was 30.77%,and the peak period is Within 1 month of onset,they need to be closely watched.2.The increase of white blood cell count may be related to the occurrence of HSPN.3.Aged 6 or higher,the rash lasts for more than 2 weeks,gastrointestinal bleeding and Increased platelet count may be the risk factors for renal damage in children with HSP.Therefore,children with HSP with the above risk factors should strengthen monitoring and follow-up,early detection and early intervention to protect renal from persistent and progressive damage.