摘要
目的探讨过敏性紫癜(HSP)患儿继发肾损害的危险因素。方法选择2019年8月至2022年10月开封市儿童医院收治的138例HSP患儿为研究对象,根据是否继发紫癜性肾炎(HSPN)分为HSP组(n=81)和HSPN组(n=57)。回顾性分析2组患儿的临床资料及实验室指标,应用多因素logistic回归分析HSPN的危险因素。结果138例HSP患儿中继发HSPN 57例,HSPN发生率为41.30%。HSPN组患儿皮疹持续时间≥4周、皮疹反复发作、有院前感染史患儿比例显著大于HSP组(P<0.05);2组患儿的性别、年龄、发病季节分布等比较差异无统计学意义(P>0.05)。HSPN组患儿血小板(PLT)、D-二聚体(D-D)、白细胞(WBC)计数水平显著高于HSP组,血清维生素C(VitC)水平显著低于HSP组(P<0.05);2组患儿的血红蛋白(Hb)、高密度脂蛋白、低密度脂蛋白、总胆固醇水平比较差异无统计学意义(P>0.05)。Logistic回归分析结果显示,皮疹持续时间≥4周、有院前感染史以及PLT、D-D、WBC计数水平升高和血清VitC水平降低是诱发HSPN的独立危险因素(P<0.05)。结论HSP患儿继发肾损害的风险较高,有院前感染病史、皮疹持续时间≥4周以及PLT、D-D、WBC计数水平升高和血清VitC水平降低与HSPN的发生密切相关。
Objective To investigate the risk factors of secondary renal damage in children with Henoch-Schonlein purpura(HSP).Methods A total of 138 children with HSP admitted to Kaifeng Children′s Hospital from August 2019 to October 2022 were selected as the study subjects,and they were divided into HSP group(n=81)and HSPN group(n=57)according to whether they had secondary Henoch-Schonlein purpura nephritis(HSPN).The clinical data and laboratory indicators of the children between the two groups were retrospectively analyzed,and the risk factors of HSPN were analyzed by logistic regression.Results Among the 138 children with HSP,57 cases had secondary HSPN,the incidence rate of HSPN was 41.30%.The proportion of children with rash onset time≥4 weeks,recurrent rash episodes,and pre-hospital infection in the HSPN group were significantly higher than those in the HSP group(P<0.05);there was no statistically significant difference in gender,age,and seasonal distribution of onset of children between the two groups(P>0.05).The levels of platelet(PLT),D-dimer(D-D)and white blood cell(WBC)count of children in the HSPN group were significantly higher than those in the HSP group,and the level of vitamin C(VitC)in serum was significantly lower than that in the HSP group(P<0.05);there was no significant difference in hemoglobin,high-density lipoprotein,low-density lipoprotein and total cholesterol of children between the two groups(P>0.05).The results of logistic regression analysis showed that rash duration≥4 weeks,pre-hospital infection,elevated PLT,D-D and WBC count levels,and decreased serum VitC level were the independent risk factors for HSPN(P<0.05).Conclusion Children with HSP have a higher risk of secondary renal damage.Pre-hospital infection,rash duration≥4 weeks,elevated PLT,D-D and WBC levels,and decreased serum VitC level are closely related to the occurrence of HSPN.
作者
方红星
胡祖霞
张涛
聂春红
FANG Hongxing;HU Zuxia;ZHANG Tao;NIE Chunhong(Department of Nephrology,Kaifeng Children′s Hospital,Kaifeng 475000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2023年第9期856-859,共4页
Journal of Xinxiang Medical University
关键词
过敏性紫癜
紫癜性肾炎
儿童
Henoch-Schonlein purpura
Henoch-Schonlein purpura nephritis
child
