小儿过敏性紫癜的复发及相关肾功能不全的相关因素分析

包淑贞; 张如峰; 吴文英; 马凤英; 李赟; 张海生

doi:10.13898/j.cnki.issn.1000-2200.2019.05.010

小儿过敏性紫癜的复发及相关肾功能不全的相关因素分析

Analysis of the related factors of affecting HSP recurrence and HSP-related renal insufficiency in children

摘要

摘要:
目的分析小儿过敏性紫癜（HSP）复发和HSP相关肾功能不全的相关因素。
方法将122例HSP患儿作为研究对象，其中38例复发者为A组，84例无复发者为B组；根据患儿尿常规检查结果，其中存在HSP相关肾功能不全41例为Ⅰ组，81例无肾功能不全者为Ⅱ组。通过单因素和多因素logistic回归分析HSP患儿复发和HSP相关肾功能不全的影响因素。
结果A组未预防用药、合并呼吸道感染史、未控制饮食、嗜酸性粒细胞（EOS）升高及未限制剧烈运动的比例较B组高（P < 0.05~P < 0.01）。Ⅰ组年龄>10岁、血小板计数（PLT）升高、白细胞数（WBC）升高、皮疹反复发作、尿微量蛋白异常、总免疫球蛋白（IgE）升高的比例较Ⅱ组高（P < 0.01）。多因素logistic回归分析结果发现，未预防用药、合并呼吸道感染史、无饮食限制、EOS升高是小儿HSP复发的影响因素（P < 0.05~P < 0.01）；年龄>10岁、PLT升高、WBC升高、皮疹反复发作、尿微量蛋白异常、IgE升高是小儿HSP相关肾功能不全的影响因素（P < 0.05~P < 0.01）。
结论小儿HSP复发的影响因素主要包括未预防用药、合并呼吸道感染史、无饮食限制、EOS升高等，导致小儿HSP相关肾功能不全的影响因素主要包括年龄、PLT、WBC、尿微量蛋白及IgE等，对存在上述影响因素的患儿，应引起临床重视和密切观察，及时干预以避免HSP复发或引起HSP相关肾功能不全。

Abstract:
ObjectiveTo analyze the related factors of affecting Henoch-Schonlein purpura(HSP) recurrence and HSP-related renal insufficiency in children.
MethodsOne hundred and twenty-two children with HSP were divided into group A(38 cases with HSP recurrence) and group B(84 cases without HSP recurrence).According to the results of urine routine examination, the HSP-related renal insufficiency in 41 cases and HSP-unrelated renal insufficiency in 81 cases were divided into the group Ⅰ and group Ⅱ, respectively.The influencing factors of HSP recurrence and HSP-related renal insufficiency in HSP children were analyzed using univariate and multivariate logistic regression method.
ResultsThe proportions of unprophylaxis, history of respiratory tract infection, uncontrolled diet, eosinophil(EOS) increasing and unrestricted exercise in group A were significantly higher than those in group B(P < 0.05 to P < 0.01).The proportions of age>10 years old, platelet(PLT) count increasing, white blood cell(WBC) increasing, repeated eruption of rash, abnormal urinary microalbuminuria and total immunoglobulin(IgE) increasing in group Ⅰ were higher than those in group Ⅱ(P < 0.05).The results of multivariate logistic regression analysis showed that the unprophylaxis, history of respiratory tract infection, uncontrolled diet and EOS increasing were the influencing factors of the HSP recurrence(P < 0.05 to P < 0.01), and the age >10 years old, PLT increasing, WBC increasing, repeated eruption of rash, abnormal urinary microalbuminuria and IgE increasing were the influencing factors of HSP-related renal insufficiency in children(P < 0.05 to P < 0.01).
ConclusionsThe influencing factors of the HSP recurrence include the unprophylaxis, history of respiratory tract infection, uncontrolled diet and EOS increasing, and the influencing factors of HSP-related renal insufficiency include the age, PLT, WBC, urinary microalbuminuria and IgE.The above factors should be paid attention to, closely observed and timely intervened to avoid HSP recurrence or HSP-related renal insufficiency.

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