儿童过敏性紫癜肾脏损害的临床相关因素分析
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Analysis of correlated factors of renal damage in Henoch-Schonlein purpura
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    摘要:

    目的:探讨儿童过敏性紫癜(HSP)肾脏损害的临床相关因素。方法:初发HSP患儿206例,分为尿检正常组(128例)及紫癜肾组(78例);紫癜肾组分为一过性尿异常组(40例)及持续性尿异常组(38例)。检测临床指标,进行统计学分析,并对尿检正常组及紫癜肾组患者,以疾病分类为应变量,以有显著性差异的临床指标为自变量,进行二分类逐步logistic回归分析。结果:40项指标中,尿检正常组及紫癜肾组单因素方差分析,有11项存在显著性差异(P﹤0.05),logistic回归分析显示,外周血中性粒细胞百分比、血白蛋白、血总胆固醇对疾病分类有显著影响(P﹤0.05)。一过性尿异常组及持续性尿异常组在年龄、皮疹持续时间等8项指标中存在显著性差异(P﹤0.05); 结论:外周血中性粒细胞百分比升高、血白蛋白降低、血总胆固醇升高是儿童HSP肾脏受累的危险因素,而年龄增长、皮疹持续、血尿合并蛋白尿、大量蛋白尿、外周血白细胞计数升高、血总蛋白、白蛋白、IgG降低,可能与肾脏持续受累有关。

    Abstract:

    Objective:To study the clinical correlated factors of renal damage in Henoch-Schonlein purpura(HSP). Methods:Two hundred and six cases with HSP treated from May 1,1999 to May 31,2004 were retrospectively studied. Based on the urinary routin examination, the patients were divided into two groups, HSP without(128 cases) or with renal damage (78 cases). In addition, based on the duration of urinary abnormality, the group of HSP with renal damage was further divided into two groups, HSP with passing(<1 week, 40 cases) or persistent(>1 week, 38 cases)urinary abnormality. Blood routin, urinary routin, biochemical examination, serum immunoglobulin, C3, C4, CIC, ASO, lymphocyte subpopulations were detected. Statistical analyses were performed using t test or chi square, a multivariate analysis(Binary Logistic Regression) to evaluate the potential factors of renal involvement. Results:In HSP group with renal damage, duration of the purpura, spread of the purpura, abdominal pain, hemorrhage of digestive tract, neutral cell percent, lymphocyte cell percent, serum total protein, serum albumin, serum urea nitrogen, serum total cholesterol and IgG were significantly different from those in HSP group without renal damage(P < 0.05). In HSP with passing urinary abnormality, age, duration of the purpura, urinary routin examination, 24-hour urinary protein excretion, white blood cell count, serum total protein, serum albumin, IgG were significantly different from those in HSP wih persistent urinary abnormality(P < 0.05). Neutral cell percent, serum albumin, serum total cholesterol were found to be independent risk factors for renal involvement, with a partial regression coefficient of 0.037(P = 0.042),-0.154(P = 0.003),0.916(P = 0.002) respectively. Conclusion:Increased neutral cell percent and serum cholesterol, decreased serum albumin are risk factors for renal involvement in HSP. In addition, duration of purpura, hematuria with proteinuria, heavy proteinuria, increase of age and neutral cell percent, decrease of serum total protein , serum albumin and IgG may be related with duration of renal damage.

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高吉照,焦玉清,卢思广.儿童过敏性紫癜肾脏损害的临床相关因素分析[J].南京医科大学学报(自然科学版),2007,(4):312-316

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  • 收稿日期:2006-08-11
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