合并生殖器受累的过敏性紫癜男性患儿的临床特征及危险因素

摘要

Objective To explore the clinical features and risk factors of Henoch-Sch?nlein purpura(HSP) boys complicated with genital involvement. Methods A total of 508 boys with HSP were enrolled,including 28 complicated with genital involvement. In the boys with genital involvement,the duration for the onset of genital involvement,clinical manifestations,ultrasound findings and clinical outcome were summarized. The risk factors for HSP boys complicated with genital involvement were analyzed. Results In the 28 HSP boys,genital involvement occurred after 9. 47 ± 4. 36 days of the onset,and onset with genital involvement was found in 2 cases. The main clinical manifestations included genital pain,swelling and/or rashes. Abnormal ultrasound findings were observed in 14 cases,and complication with testitis was common. The remission of genital rashes occurred after 8. 02 ± 1. 43 days of treatment, genital pain and/or swelling occurred after 3. 96 ± 0. 82 days of treatment. Younger age,digestive bleeding,scalp and soft tissues swelling and elevated D-dimer level were the risk factors for HSP boys complicated with genital involvement(all P<0. 05). Conclusion HSP boys complicated with genital involvement have special clinical characteristics and relatively severe symptoms, but can achieve good outcome after treatment. Genital involvement should be paid attention to in the younger boys,or boys with digestive bleeding,scalp and soft tissues swelling and elevated D-dimer level.%目的 探讨合并生殖器受累的过敏性紫癜(HSP)男性患儿的临床特征及危险因素.方法 选择508例HSP男性患儿,其中28例合并生殖器受累.总结生殖器受累患儿的生殖器受累时间、临床表现、超声检查结果及临床转归,分析HSP患儿合并生殖器受累的危险因素.结果 28例HSP患儿生殖器受累发生于起病后的(9. 47 ± 4. 36)d,有2例以生殖器受累为首发表现,主要临床表现包括生殖器疼痛、肿胀和(或)皮疹;其中14例患儿超声检测存在异常,合并睾丸炎较常见.患儿的生殖器皮疹在治疗后(8.02 ±1.43)d缓解,生殖器疼痛和(或)肿胀在治疗后(3.96 ±0.82)d缓解.年龄小、消化道出血、头皮和软组织肿胀及D-二聚体水平升高是HSP男性患儿生殖器受累的危险因素(均P<0. 05).结论 HSP合并生殖器受累男性患儿具有特殊的临床特点,且症状相对较重,但经积极治疗后预后佳.对于年龄偏小、存在消化道出血、头皮和软组织肿胀、D-二聚体升高的男性患儿,应警惕生殖器受累.