| Objectives Analysis of 101 children with Henoch-Schonlein purpura pathogenesis,general situation,clinical characteristics,laboratory examination,allergen screening and other related results,summarized the characteristics of renal injury in HSP with different extrarenal manifestations.By comparing various laboratory test results between Henoch-schonlein purpura nephritis children and non HSPN children,we can improve the understanding of the disease,provide theoretical basis and guidance for the prevention,diagnosis,treatment and prognosis of HSP children,and further explore the relevant risk factors of renal damage.Methods The clinical data,laboratory results,kidney injury and pathological data of 101hospitalized children diagnosed with HSP who visited the Department of Pediatrics of Hebei General Hospital from June 2016 to June 2021 were collected.The causes of the disease and the screening of allergens were summarized to understand the pathological characteristics of children with kidney injury.Statistical analysis was made on the differences of HSP with different extrarenal manifestations.By comparing the results of non HSPN group and HSPN group,the significance of blood routine,biochemistry,immune system and coagulation in the diagnosis of HSPN was clarified.Results 1 Among the 101 hospitalized children with HSP,69(68.3%)were boys and 32(31.7%)were girls,with a male to female ratio of 2.15:1.The onset age of HSP children ranged from 3 to 14 years old,the length of hospital stay was 4-22 days,and the average length of hospital stay was(9±3)days.Henoch purpura occurred throughout the year,with24 cases(23.8%)in spring,15 cases(14.9%)in summer,36 cases(35.6%)in autumn,and26 cases(25.7%)in winter.2 Infection was the leading cause of HSP,and the main types of infection were upper respiratory tract infection(40 cases),bronchopneumonia(2 cases),bronchial infection(5 cases)and digestive tract infection(1 case).Statistics showed that 21cases(20.8%)were streptococcal infection,3 cases(3.0%)were mycoplasma and chlamydia infection,and 1 case(1.0%)was parainfluenza virus infection.Among 101children with HSP included,75(74.3%)underwent allergen screening and 21(20.8%)did not.3 All the children showed skin purpura(100%),joint symptoms in 46 cases(45.5%),digestive tract symptoms in 42 cases(41.6%),kidney damage in 23 cases(22.8%).Purpura was mainly distributed in lower limbs,followed by buttocks,upper limbs,hands,back of feet and trunk.The proportion of skin purpura accompanied by joint swelling and pain and digestive tract symptoms with kidney injury was the highest(P<0.05).4 There were statistically significant differences in WBC,ASO,urine red blood cell and white blood cell count(P<0.05).In humoral immunity,there were statistically significant differences in Ig A and complement C3 between HSPN and non HSPN group(P<0.05),there were no significant differences in other indexes between the two groups.The percentage of total T lymphocyte CD3~+and T lymphocyte CD4~+in HSPN and non HSPN groups were significantly different in cellular immunity(P<0.05),and there was no significant difference in other indexes.There were statistically significant differences in D-D and PT between HSPN group and non HSPN group(P<0.05),the remaining indexes had no statistical significance.Further Logistic regression analysis of significant indicators showed that the OR values of Ig A,ASO,PT and D-D were statistically significant(P<0.05).Conclusions 1 Henoch-Schonlein purpura occurs all the year round.The most common infection type among the pathogenic causes is acute upper respiratory tract infection,and the most common pathogen is Streptococcal infection.2 The proportion of renal damage in HSP children with skin purpura accompanied by joint symptoms and gastrointestinal symptoms was the highest,with statistical significance.3 The WBC,ASO,C3,PT,D-D,CD3~+,CD4~+,urine red blood cell and white blood cell count of HSPN and non HSPN children were statistically significant.4 Ig A,ASO,PT and D-D are independent risk factors for kidney injury,and children with elevated corresponding indexes need more close attention,enhanced follow-up,early detection and early treatment.Figure 3;Table 7;Reference 184... |
