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目的探讨儿童紫癜性肾炎(HSPN)发病的危险因素。方法对2009年1月-2011年12月就诊于新疆医科大学第一附属医院儿科的296例确诊为过敏性紫癜(HSP)患儿的一般情况、临床表现、实验室数据、过敏原检测结果等临床资料进行回顾性分析,并对易感因素进行逐步Logistic回归分析。296例患儿中有116例(39.1%)出现肾脏损害,男女之比为1.24∶1。结果发病因素中感染居首位(49.0%)。HSPN组平均发病年龄为(9.20±2.70)岁,比非HSPN组年龄偏大。HSPN组皮肤紫癜反复发作与消化道出血者的肾脏损害率明显高于非HSPN组(P<0.05)。胆固醇、甘油三酯偏高及白蛋白降低与HSPN的发生有关,组间比较差异有统计学意义(P<0.05)。结论皮疹反复情况、消化道出血、胆固醇、甘油三酯、白蛋白可能是影响HSP预后的危险因素,对其应给予密切关注,采取积极措施及早发现、及早治疗,预防肾损害的发生和发展。
Objective To investigate the risk factors for the development of children’s purpura nephritis (HSPN). Methods From January 2009 to December 2011, 296 children with Henoch-Schonlein purpura (HSP) who were diagnosed in the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively. The clinical manifestations, laboratory data, allergen test results, etc. The clinical data were retrospectively analyzed and stepwise logistic regression analysis was performed on the predisposing factors. Of the 296 children, 116 (39.1%) developed kidney damage with a ratio of 1.24: 1. Results The highest incidence of infection among pathogens (49.0%). The mean age of onset in HSPN group was (9.20 ± 2.70) years old, which was larger than that in non-HSPN group. HSPN skin purpura recurrent and gastrointestinal bleeding renal damage was significantly higher than non-HSPN group (P <0.05). Cholesterol, triglyceride high and albumin decreased with the occurrence of HSPN, the difference was statistically significant (P <0.05). Conclusions The recurrence of rash, gastrointestinal bleeding, cholesterol, triglyceride and albumin may be risk factors for the prognosis of HSP. Close attention should be paid to them, and active measures should be taken to detect them early and early to prevent the occurrence and development of renal damage.