Clinical Analysis Of Mycoplasma Pneumoniae Infection Associated With Henoch-Schonlein Purpura In 160 Children

Objective:To know about the clinical characteristics of mycoplasma pneumoniae infection associated with HSP in children,strengthen the clinical understanding,and minimize the complications of renal damage.Methods:The clinical data of 1236 children who were admitted to the department of rheumatology and immunology of the children's hospital affiliated to Soochow University and diagnosed as Henoch-Schonlein purpura during SEP.2016 to AUG.2018 were retrospectively analyzed.Divided groups as follows:the HSP infected by Mycoplasma pneumoniae was set as the observation group,and the non-infected HSP was set as the control group.Among them,there is 160 children has infected HSP,accounting for 12.94%of the total HSP cases and 94 children has non-infected HSP.The children were collected blood on the same day of admission,and the antibodies against Mycoplasma pneumoniae were detected by indirect enzyme-linked immunosorbent assay.Routine blood test,allergen test,liver function,renal function,urine protein set,24-hour urine protein and other pathogen tests,abdominal ultrasound,and chest film were performed.There was no statistically significant difference in gender and age between the two groups(P>0.05),which was comparable.The clinical manifestations and time of regression or significant improvement,renal damage,rash number,hospitalization time and some laboratory tests were compared.Both groups were given diets based on allergen detection and clinical symptoms,anti-Henoch-Schonlein and symptomatic treatment,and treated with hormones and immunosuppressive agents according to the condition.Statistical Methods Data were processed using SPSS 22.0 statistical software.Results:1.Comparison between Mycoplasma pneumoniae infected allergic purpura(MP-HSP group)and allergic purpura without any infection(no infection-HSP group):160 cases of MP-HSP group accounted for 12.94%of total HSP cases(160/1236),86 males and 74 females,the ratio of male to female is 1.16:1.The age distribution is from 11 months old to 14 years and 4months old,the average age is 6.72±2.44 years old;There are 94 cased of no infected HSP group,51 males and 43 females.male to female ratio of 1.19:1,age distribution is 2 years and 3 month old to 13 years and 8 month old,the average age is 7.32±2.85 years old.There was no significant difference in gender and age between the two groups(both P>0.05),which was comparable.There was no significant difference between the MP-HSP group and Non-infected-HSP group in seasons(P>0.05).The hospital stay time(greater than or eaqual to 9 days)and rash recurrence in the MP-HSP group(Recurrence occurs when the rash is repeated twice or more)was more than that in non-infected-HSP group,the difference was statistically significant(P<0.05).2.The clinical comparison of the observation group and the control group:2.1.There was no significant difference in the incidence of skin type,articular type and mixed type between the two groups(P>0.05).2.2.The incidence of renal type in theMP-HSP group was higher than that in the non-infected-HSP group,with a statistically significant difference(P<0.05).2.3.The incidence of abdominal type in the observation group was lower than that in the control group,with a statistically significant difference.(P<0.05).3.Compared time difference in the skin purpura regression or improvement time,disappearance time of gastrointestinal tract,articular symptoms between the observation group and the control group,there was no significant difference.(P>0.05)4.Comparison of HSPN incidence in the two groups:HSPN incidence in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).5.Comparison of clinical classification of HSPN between the two groups:from the perspective of distribution,clinical classification of the observation group focused on three types of hematuria and albuminuria acute nephritis nephrotic syndrome,while the clinical classification of the control group mainly focused on isolated hematuria or albuminuria acute nephritis with statistically significant differences(P<0.05).6.In the two groups in HSPN(glomerulus)on the pathological type:87 cases of children with HSPN,19 cases in MP-HSP group were given renal pathologic examination,distributed on class ?b,?a and ?b;Non-infection HSP group,11 cases were given renal pathologic examination,distributed on class ? a,? b,and ? a.The pathological type of MP-HSP group was more severe than that of no infection group,and the difference was statistically significant(P<0.05).7.Comparison of laboratory examination indexes between the two groups:7.1 peripheral blood routine:White blood cell count(WBC)(×109),neutrophil percentage(N)(%),and platelet count(Plt)(×109)showed no significant difference between the two groups(P>0.05),and C-reactive protein(CRP)mp-hsp group was significantly higher than that of the non-infection-hsp group,with statistically significant differences(P<0.05).7.2 creatinine,urea nitrogen,uric acid:there was no significant difference between the two groups(P>0.05).Cystatin C and total urinary protein at 24 hours upon admission were significantly higher in the observation group than in the control group,with statistically significant differences(P<0.001).Conclusion:1?Mycoplasma pneumoniae infection is one of the common causes of allergic purpura,accounting for 12.94%of the total cases of allergic purpura.2?Compared with the group without infectious allergic purpura,the incidence of mycoplasma pneumoniae infection-related allergic purpura nephritis was higher and the incidence of abdominal type was lower.Its nephritis pathological type is more serious,disease course is longer.