Analysis Of Clinical Characteristics Of Children With Henoch-sch(?)nlein Purpura And The Risk Factors Of Henoch-sch(?)nlein Purpura Nephritis

Objective Henoch-Sch(?)nlein purpura(HSP)is the most common leukocyte rupture vasculitis in childhood.When HSP vasculitis involves the kidneys and renal damage occurs,it is named Henoch-Sch(?)nlein purpura nephritis(HSPN).Whether or not the kidney is damaged and the degree of injury determines the prognosis of HSP,and when the HSPN is prolonged,it can gradually develop into chronic kidney disease,affecting the physical and mental development of the children.Therefore,early detection,early diagnosis and treatment of renal injury in HSP is of great importance.The purpose of this study is to analyze the clinical characteristics of HSP and the risk factors of HSPN,so as to provide a theoretical reference for the diagnosis and treatment of HSP and HSPN and the improvement of prognosis.Methods A unified data collection table was designed to collect the case data of 186 children who were first diagnosed with HSP and visited the pediatrics department of the First Affiliated Hospital of Shihezi University Medical College between January 1,2015 and July 31,2020 and who met the inclusion criteria for HSP.The data included basic information,clinical symptoms and related test results of children with HSP.HSP children were divided into two groups: HSPWN group(n =131)and HSPN group(n =55)according to whether or not they had renal damage.The statistical software SPSS 20.0 was used for statistical analysis of the case data,and the data differences between the two groups were compared,the difference was statistically significant at P<0.05.The independent risk factors of HSPN were analyzed by unconditional multivariate Logistic regression model,the difference was statistically significant at P<0.05.Results1.General situation: Among the 186 cases of HSP,97 cases were boys(52.15%)and 89 cases were girls(47.85%),with a male-to-female ratio of 1.09:1 and a median age of 7 years.The incidence of HSPN was 29.57%,the male-to-female ratio was 1.2:1,and the median age was 8 years.The HSPWN group and the HSPN group were analyzed for age,gender,prodrome infection,allergen and other factors: the average age of children in the HSPN group was significantly higher than that in the HSPWN group,and the difference was statistically significant,P< 0.05.2.Clinical manifestations: During the course of disease,all HSP children showed signs of skin purpura,44.09% of the children had symptoms of abdominal pain and hematochezia,39.25% of the children had non-invasive arthritis and joint pain,29.57% of them showed symptoms of renal damage.The clinical manifestations of the two groups were compared: there were statistically significant differences in the duration of skin purpura,recurrent times of skin purpura,and abdominal pain,hematochezia symptoms,P< 0.05.3.Laboratory examination: WBC,NEU,PLT,RDW,CRP,ALB,Cys C,APTT,FIB,D-D,Ig A and C4 in the peripheral blood of the two groups were compared with each other,and the difference was statistically significant,P< 0.05.4.Logistic regression model was used to analyze the independent risk factors for HSPN.The results showed age(P=0.040,OR=1.358,95%CL > 1),recurrent times of skin purpura(P=0.043,OR=2.838,95%CL>1),RDW(P=0.004,OR=2.814,95%Cl﹥1),CRP(P=0.011,OR=1.39,95%Cl﹥1),D-D(P=0.000,OR=2.589,95%Cl﹥1),Ig A(P=0.009,OR=2.090,95%Cl﹥1),Cys C(P=0.005,OR=9.227,95%Cl﹥1),The above 7 factors were considered as independent risk factors for HSPN.Conclusion1.The incidence of Henoch-Sch(?)nlein purpura nephritis in Henoch-Sch(?)nlein purpura in this study was 29.57%.2.Age of onset,duration of skin purpura,recurrent times of skin purpura,with or without gastrointestinal symptoms,peripheral blood indicators WBC,NEU,PLT,RDW,CRP,ALB,Cys C,APTT,FIB,D-D,Ig A,C4 were correlated with the occurrence of HSPN in HSP children.3.Age of onset,recurrent times of skin purpura,RDW,CRP,D-D,IgA and Cysc in children with HSP were independent risk factors for the occurrence of HSPN.