Analysis On Clinical Characteristics Of 329 Pediatric Patients Of Henoch-sch(?)nlein Purpura

Objective In order to sum up characteristics of various types of Henoch-Sch?nlein Purpura(HSP),the researcher made analysis of clinical manifestation of 329 HSP patients and took reference to related inspection results.By comparing various HSP types based on the first visit,HSP patients and healthy children,as well as HSPN patients and HSP patients without renal impairment,the diagnostic significance of each item of inspection results was clarified.Method In total,the clinical materials,inspection results and follow-up status of all 329 hospitalized children from January 2014 to December 2017 after diagnosed as HSP through the first visit have been collected.By summarizing the causes and initial symptoms of HSP,researcher collected and made analysis of their clinical inspection results of various types of HSP patients and their differences in renal impairment appearing in the final stage.With comparison of other 62 healthy children,the significance of relevant inspections in HSP diagnosis was illustrated.And through comparison of inspection results between group without renal impairment and HSPN group,the diagnostic significance of blood test and five indexes of urinary protein series inspection toward HSPN was clarified.Result The onset age of HSP varies from 1 to 15 years old,and its onset male-to-female ration of 1.208:1.Usually,the onset of HSP mainly occurs in autumn and winter(69.3%),with an average onset age of 7.0+2.3 years.Infection(46.50%)can be the major predisposing factor,followed by allergy(7.90%)and exercise(1.52%).The primary sysmtoms were mainly rash(90.88%),then followed by joint symptoms(5.47%)and abdominal symptoms(3.65%).And most of the rashes were first time found at lower limbs,next buttocks and trunk,upper limbs,hands,dorsum of feet,perineal region and face.The rashes at perineal region was easy to get combined and lead to neuro myxoedema.There was no significant correlation between the initial andrecurrent sites of rash.The accompanied symptoms are considered main basis for HSP clinical classification.For children of abdominal type,the major symptom was paroxysmal abdominal pain,but no occurrence of intestinal perforation or intestinal obstruction was found.In the follow-up process,children of joint type all did not leave any joint sequela.Among all HSP types,the simple type of patients has the lowest proportion to get renal impairment while the hybrid type of patients has the highest one.Through statistic,it was found that inspection results of WBC,PLT,Hb,ASO,ESR,CRP,IgG,IgM all have no statistical significance(P>0.05)no matter between HSP group and healthy control group,different types of HSP,or HSPN group and HSP group without renal impairment,which means the inspections above have no special significance to disease diagnosis.Besides,the levels of IgA,C3 and D-D are higher in HSP group than those of healthy group(P<0.05).Meanwhile.these indexes are higher in hybrid HSP group than those of other groups(P<0.05)and are also higher in HSPN group than HSP group without renal impairment(P<0.05).That shows these three indexes mentioned above can be taken as the monitoring objects of HSP occurrence and development,in the meantime they are also the dangerous indexes indicating the occurrence of renal impairment,which requires intensive monitoring.The occurrence rate of renal impairment for HSP patients is 10.94%,and most cases occur within 6weeks(94.44%).About the urinary protein series inspection,the levels of indexes including UIgG,NAG and UTRF are obvious higher in HSPN group than those of HSP control group(P<0.05).When compared to levels of U?2-MG and URBP,it can have greater significance for identifying the renal impairment at the early stage.Conclusion Infection is regarded the main cause of HSP onset;simple type of HSP has the lowest proportion of getting renal impairment and hybrid type of HSP has the highest proportion.In the blood test,the increasing levels of IgA,C3,D-D have greater diagnostic significance to occurrence of HSP and progression of disease,whichare also critical factors that lead to renal impairment and can be taken as the intensive monitoring indexes.For HSPN patients,the increasing levels of UigG,NAG and UTRF in the urinary protein series inspection have more clinical significance.