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1、临床医学论文■儿童过敏性紫瘢336例临床分析【摘要】目的:探讨儿童过敏性紫瘢(HSP)的临床特点和治疗方案。方法:对2001年8月〜2007年10月在本院住院的336例过敏性紫瘢患儿的发病特点、临床表现、肾损害相关因素及预后等方面进行回顾性分析。结果:(1)2001〜2007年每年的住院构成比依次为0.91%、1・12%、1・25%、1・28%、1・35%、1.48%及1.71%。(2)农村患儿213例,占63.39%。(3)诱因:感染因素216例(64.29%),进食特殊食物引起64例(19.04%),药物引起56例(16.67%)。(4)冬季发病148例(44.04%),春
2、季发病130例(38.69%)。(5)出现肾脏症状64例(19・04%),出现关节症状74例(22.02%),出现消化道症状70例(20.82%)。(6)血清IgA升高58例(17.26%),IgE升高102例(30.35%)。(7)预后:治愈276例(82.14%),好转32例(9.52%)。结论:(1)HSP患病率有逐年升高趋势;农村患儿发病较多;冬春季好发。(2)发病诱因仍以感染为第一位。(3)要重视儿童过敏性紫瘢的多系统损害,如皮肤、关节、消化道、肾脏等。(4)发病与上呼吸道感染和机体免疫功能紊乱有关。【关键词】儿童紫瘢过敏性临床特点ClinicalAnalysisof
3、336ChildrenwithHenochSchonleinPurpuraZHOUBin,LILida(XuzhouCentralHospitalofJiangsuProvince,JiangsuXuzhou221009,China)[Abstract]Objectivc:TostudytheclinicalcharacteristicsandtreatmentofchildrenwithHenochSchonleinpurpura(HSP).Methods:336caseswithHSPhospitalizedinourhospitalfromAugust,2001toOct
4、ober,2007wereretrospectivelystudiedontheirpatternsofonset,clinicalmanifestations,correlatedfactorsofrenaldamageandoutcomes.Results:(1)TheconstituentratioofhospitalizationofHSPwas0.91%,1.12%,1.25%,1.28%,1.35%,1.48%and1.71%from2001to2007,respectively.(2)Amongthe336cases,213(63.39%)werefromrura
5、larea.(3)Inducingfactors:infections(216cases,64.29%),specialfood(64eases,19.04%)anddrugs(56cases,16.67%).(4)Winter148cases(44.04%),Spring130cases(38.69%)・(5)Totally64cases(19.04%)presentedsymptomsofrenaldamage,74cases(22.02%)presentedsymptomsofjointsymptoms,70cases(20.82%)presentedsymptomsof
6、gastrointestinaltractsymptoms.(6)IncreasedIgAinscrumin58cases(17.26%),increasedIgEin102cases(30.35%).(7)Pprognosis:276(82.14%)caseswerecured,32cases(9.52%)weregreatlyimproved.Conclusions:(1)MorbidityofHSPincreasesyearbyyear.Morbidityishighinthechildrenfromruralareaandalsohighhighwheninwinter
7、andspring.(2)Themostimportantinducingfactorisinfection.(3)SpecialattentionshouldbepaidtomultisystemdamageinHSP,includingskin,joint,gastrointestinaltractandrena1.(4)HSPhasrelationwithupperrespiratorytractinfectionandfunctionaldisorderofimmunesystem.