Analysis Of Clinical Features Of 811 Cases Of Henoch-Schonlein In Children

Objectve: To systematically collect and count 811 hospitalized patients with HSP(?16 years old)in the Department of Pediatrics,First Affiliated Hospital of Anhui Medical University from January 2012 to December 2016,and to deepen the understanding of the disease,so as to provide clinical basis for timely diagnosis,treatment and improvement of the prognosis of HSP.Methods: Using Excel software,811 cases of Henoch-Schonlein related information diagnosed in our department from January 2012 to December 2016 were recorded and retrospectively analyzed using statistical software SPSS 19.00.Grouping: 1.According to the age of the childen at the time of onset,divided into the early childen group(year?3 years),preschool group(3 years<year<6 years),school age group(6years?year? 10 years),adolescent group Group(year>10 years);2.According to clinical manifestations,divided into group A(simple Henoch-Schonlein),group B(Articula Henoch-Schonlein),group C(abdominal Henoch-Schonlein),group D(renal Henoch-Schonlein),group E(complex Henoch-Schonlein);3.According to the presence or absence of joint involvement symptoms,there are no joint involvement group and joint involvement group.with or without gastrointestinal symptoms,divided into digestive tract involvement group and non-digestive tract involvement group.According to urine routine and abnormal renal function it was divided into renal involvement group and no kidney involvement group.According to the above grouping,the differences in clinical performance and laboratory test results between groups were compared.For the kidney affected group and the no kidney affected group,further analysis of the linear correlation between immunoglobulin,complement and their ratio in the renal involvement group,and the value of the statistically significant test indexand the optimal cut-off point were evaluated by ROC curve.Results:1.The incidence of boys is higher than that of girls,and the peak incidence of HSP is 4-12 years old.2.Infection is the most common cause of the disease,especiallyrespiratory infections,high in autumn and winter.There was a strong positive linear correlation between the incidence of children with allergic purpura and respiratory infections in each month.3.The main clinical manifestations are typical rash,abdominal pain,joint pain and renal dysfunction.Among them,rash is the first symptom.4.The main distribution is mainly in the large joints such as knees,ankles,wrists and elbows.The other joints are rare,and a few can involve the lower back and the metacarpophalangeal joints,mainly involving bilateral symmetry.There was a statistically significant difference in whether or not the affected area of the rash was >3 and its joint muscle involvement(p<0.05).Children in the school age group and the elderly group were susceptible to joints.5.Patients with allergic purpura with multiple lower extremity rash infection,hip rash infection,upper extremity rash involvement,more than 3 cases,male children,joint symptoms,and respiratory tract infections are more susceptible to digestive tract.The respective levels of NLR,IgG,IgA,ESR,and CRP were statistically different from the digestive tract involvement or unaffected(P <0.05);elevated ESR(>15 mm/h)and elevated CRP(>10 mg/L),mycoplasma infection,HP infection were statistically significant in the involvement of the digestive tract(P <0.05).NLY and CRP had moderate diagnostic efficacy for digestive tract involvement(0.5 < AUC <0.7,P < 0.05)6.Children with allergic purpura with lower limbs,buttocks,upper extremities,perineal rash,and allergic purpura with joint symptoms,gastrointestinal symptoms,and respiratory infections are more susceptible to kidney disease.The levels of NLR,IgG,and IgA were statistically different in renal involvement or unaffected(P < 0.05).7.There was a positive linear correlation between IgG and IgM in the renal involvement group,suggesting that IgG and IgM interact with each other.The role may play a role in the HSP progressing to HSPN.IgA,IgG,IgM,and IgA/C3,IgG/C3,IgM/C3,and IgA/C4 were significantly different between the renal involvement and non-renal involvement in the acute phase HSP,but the efficacy comparison suggested IgM,Compared with other indicators,IgM/C3 is more sensitive to predicting the progression of allergic purpura to HSPN.IgM is better than IgM/C3.8.the levels of Platelet count,erythrocyte sedimentation rate,ASO,DD,IgG,IgA in clinical classification of allergic purpura There were differences in the type(P<0.05),elevated erythrocyte sedimentation rate(>15mm/h),and platelet elevation >300*10^9/L.There were also differences in the clinical classification of allergic purpura(P<0.05).Conclusion:1.The incidence of HSP boys is higher than that of girls,4-12 years old is the peak incidence of HSP,high incidence in autumn and winter.Respiratory tract infection is the primary cause of Henoch-Schonlein purpura.Children older than 4 years and younger than 10 years are susceptible to joint involvement,mostly symmetrical involvement of major joints of limbs.2.The digestive tract of HSP children infected with Mycoplasma and HP is more susceptible to infection.The imbalance of NLY and CRP played an important role in the development of digestive tract involvement in Henoch-Schonlein purpura.NLY and CRP had low efficacy for digestive tract involvemen(0.5 < AUC<0.7,P < 0.05).3.It is speculated that the disorders of NLR,IgG and IgA may play a role in renalinvolvement.4.IgM secretion imbalance plays an important role in the development of renal involvement in allergic purpura,and can be used as a performance indicator of HSPN(0.5<AUC0.7,P<0.05),and it has a positive correlation with IgG in HSPN,suggesting a certain relationship in the progress of HSPN.5.The long-term prognosis of HSP is good,mainly affected by the degree of renal involvement and its recovery.Individual children have repeated urinary protein and develop renal insufficiency.