Analysis Of Risk Factors Associated With Children Henoch-Sch?nlein Purpura With Gastrointestinal Or Renal Involvement

Objective:Aim to summarize the regularity of children Henoch-Sch?nlein purpura(HSP)and provide theoretical support for its early prediction and intervention through analyzing the inducements,clinical manifestations,laboratory examinations and the risk factors of children HSP with gastrointestinal or renal involvement.Methods:We performed a retrospective analysis of children HSP patients who presented at Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,between January 2016 and December 2017.The eligible cases were screened out for our research.Original data of clinical characteristics included sex,age,inducements,clinical manifestations,laboratory examinations,therapeutic drugs and length of hospitalization.Statistical analysis software SPSS 22.0 was used for data processing and analyzing.Results:A total of 241 children patients were included.Among them,147(61.0%)patients presented gastrointestinal involvement,and 74(30.7%)patients presented renal involvement.The results of univariate analysis showed that the onset age over 7 years old,white blood cell count(WBC)over 9.5×10~9/L,neutrophil granulocyte ratio(NE%)over 60%and D-dimer(D-D)over 1.5mg/L were significant difference between the gastrointestinal involvement group and non-involvement group(P<0.05).Besides,the onset age over 7 years old and complement C3(C3)less than 0.79 g/L were found significant difference between the renal involvement group and non-involvement group(P<0.05).Logistic multi-factors regression analysis showed that the onset age over 7years old and WBC over 9.5×10~9/L were independent predictors of children HSP with gastrointestinal involvement(P<0.05).The onset age over 7 years old and C3 less than0.79 g/L were independent predictors of children HSP with renal involvement(P<0.05).Additionally,among all patients in our study,the utilization ratio of antihistamine ranked first with a rate of 83.8%,followed by antibiotics with a rate of 71.8%,glucocorticoids at58.5%,angiotensin converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ARB)at 6.6%,and antiplatelet aggregation/anticoagulation drugs with a rate of 34.4%.Conclusion:Gastrointestinal and renal involvements universally occurred in children HSP.In the present study,we found that the onset age over 7 years old,WBC over 9.5×10~9/L,NE%over 60%and D-D over 1.5 mg/L may be risk factors for gastrointestinal involvement of children HSP.The onset age over 7 years old and C3 less than 0.79 g/L may be risk factors for renal involvement of children HSP.Thus,more attention,timely and effective clinical intervention and prolonged follow-up should be taken to those children HSP patients to reduce complications and improve prognosis.Besides,ACEI/ARB can improve moderately severe proteinuria and delay the progression of kidney damage.Clinicians should use these drugs reasonablely to treat children with HSPN.