摘要
目的:分析过敏性紫癜(HSP)患儿早期肾损伤临床特点及相关因素。方法:选取2023年1月~2024年3月我院收治的HSP患儿101例为研究对象,依据是否伴有早期肾损伤分为损伤组(n=38)、非损伤组(n=63),对比两组一般资料、实验室指标,分析早期肾损伤影响因素。结果:与非损伤组患儿相比,损伤组年龄、HSP皮肤型、发病季节、抗链球菌溶血素O水平、累及关节情况未见差异(P>0.05);而男童、皮疹持续时间≥3 w、皮疹反复发作、有腹痛、有消化道出血者比例显著高于非损伤组(P<0.05)。损伤组白细胞计数(WBC)、纤维蛋白(FIB)、血小板计数(PLT)、低密度脂蛋白(LDL)、D-二聚体(D-D)、免疫球蛋白(Ig)A、IgM、IgE、中性粒细胞和淋巴细胞比值(NLR)均高于非损伤组。多因素Logistic回归分析显示,皮疹持续时间≥3 w、皮疹反复发作、消化道出血、FIB、PLT、HDL、D-D、IgA、IgE、NLR为HSP影响患儿是否发生早期肾损伤的独立因素(P<0.05)。结论:皮疹持续时间、皮疹反复发作、消化道出血、FIB、PLT等是影响HSP患儿是否发生早期肾损伤的重要因素,临床需关注这些危险因素,加强其监护与随访。
Objective:To analyze the clinical characteristics and influencing factors of early renal injury in children with HSP.Methods:A total of 101 children with HSP were admitted to the hospital from January 2023 to March 2024.They were selected as the study subjects,and divided into injury group(n=38)and non-injury group(n=63).The general data and laboratory indexes of the two groups were compared to screen the risk factors of early renal injury.Results:Compared with the non injury group,there was no significant difference in age,HSP skin type,onset season,anti streptolysin O level,and joint involvement between the injury group and the non injury group(P>0.05);The proportion of boys with rash duration≥3 weeks,recurrent rash,abdominal pain,and gastrointestinal bleeding was significantly higher than that of the non injury group(P<0.05).The white blood cell count(WBC),fibrinogen(FIB),platelet count(PLT),low-density lipoprotein(LDL),D-dimer(D-D),immunoglobulin(Ig)A,IgM,IgE,neutrophil to lymphocyte ratio(NLR)in the injury group were all higher than those in the non injury group.Multivariate logistic regression analysis showed that rash duration≥3 weeks,repeated rash attacks,gastrointestinal bleeding,FIB,PLT,HDL,D-D,IgA,IgE,NLR were independent influencing factors for early renal injury in HSP patients(P<0.05).Conclusion:Skin rash duration,recurrent skin rash,gastrointestinal bleeding,FIB and PLT are important influencing factors of early renal injury in children with HSP.Clinically,attention should be paid to these risk factors,monitoring and follow-up should be strengthened.
作者
张敬富
黄娟荣
Zhang Jing-fu;Huang Juan-rong(Department of Pediatrics,De'an Hospital of Traditional Chinese Medicine,Jiujiang 330400,Jiangxi,China;Department of Child Care,Nanfeng Maternal and Child Health Hospital,Fuzhou 344500,Jiangxi,China)
关键词
过敏性紫癜
儿童
早期
肾损伤
临床特点
影响因素
Henoch-Schonlein purpura
Children
Early stage
Renal injury
Clinical characteristic
Influencing factor
