成人及儿童过敏性紫癜在临床表现和预后中的差异

摘要

Objective To investigate the differences in clinical manifestations and prognosis between adult and child Henoch-Schonlein purpura(HSP).Methods The data in 320 cases of HSP in Zhengzhou Municipal Children′s Hospital and First Affiliated Hospital of Zhengzhou University from November 2013 to December 2016 were retrospectively analyzed.Then the differences in clinical manifestations and prognosis between adult and child HSP were compared.Results Purpura was mainly distributed in double lower limbs,but the proportion of double upper extremities distribution in adults was higher than that in children(43.8%vs.20.1%).Child HSP was easier to appear the joint symptoms than adult HSP(55.4% vs.26.0%),adult HSP was easier to ap-pear diarrhea(20% vs.1.6%);adult HSP was easier to appear serum IgA level increase and anemia(26.3% vs.3.5%,25% vs. 7.1%).Renal injury in adult HSP was more severe than that in children(78.1% vs.29.0%);the 31-month follow up found that the proportion of adult HSP progressing to chronic renal insufficiency was 9.4%,which in child HSP was 1.3%.Conclusion The great differences in the HSP clinical manifestations exist between adult and child HSP.Adult HSP is easier to appear renal involve-ment and its prognosis is poorer.%目的 探讨成人和儿童过敏性紫癜在临床表现和预后中的差异.方法 回顾性分析2013年11月至2016年12月郑州儿童医院和郑州大学第一附属医院就诊的过敏性紫癜患者320例的资料,比较成人及儿童过敏性紫癜在临床表现和预后的差异.结果 紫癜主要分布于双下肢,但分布于双上肢的比例成人高于儿童(43.8% vs.20.1%);儿童过敏性紫癜较成人更容易出现关节症状(55.4% vs.26.0%);成人过敏性紫癜较儿童更容易出现腹泻(20% vs.1.6%);成人过敏性紫癜患者更容易出现血清IgA水平的升高和贫血(26.3% vs.3.5%,25% vs.7.1%).成人过敏性紫癜患者的肾损害较儿童更严重(78.1% vs.29.0%);进行31个月的随访后发现成人过敏性紫癜进展至慢性肾功能不全的比例是9.4%,儿童是1.3%.结论 成人和儿童过敏性紫癜在临床表现上存在巨大差异;成人过敏性紫癜更容易出现肾脏受累及肾脏受损的预后更差.