Analysis Of Clinical Risk Factors Of Gastrointestinal Bleeding In Children With Henoch-Schonlein Purpura

Objective:Allergic purpura(Henoch-Schonlein-purpura,HSP)for children,frequentlyoccurring disease,is a kind of accumulation body small blood vessels of IgA vasculitis,main show is clinically platelets of itp abdominal pain joint swelling pain,bloody hematuria and proteinuria when HSP involving the digestive tract,the digestive tract bleeding,important influence on the short-term prognosis of children will,often need to fasting,gastrointestinal decompression on the treatment Even surgical treatment,such as apparent extended with length of hospital stay,the increased use of health care costs,and in recent years,the study of allergic purpura in children,the study of the main focus is purpura nephritis,gastrointestinal bleeding of allergic purpura research,therefore,whether can you through some clinical features and laboratory examination index to predict the occurrence of gastrointestinal bleeding is becoming a hot spot of research,therefore,this article aims to explore children HSP clinical risk factors for gastrointestinal bleeding,forecasting the occurrence of the digestive tract hemorrhage,in order to guide treatment,improve prognosis,reduce medical costs.Methods:Retrospectively analyzed the clinical data of 112 cases of children with allergic purpura,according to the presence of the digestive tract hemorrhage were divided into group 45 cases of gastrointestinal bleeding,the digestive tract hemorrhage group 67 examples,compare two groups: the general clinical data including: age distribution is there a gender rash onset season cause joint swelling pain symptoms such as abdominal pain and vomiting edema the WBC HB PLT N L NLR PLR D-dimer Fbg Single factor statistical analysis was performed on the data of the two groups for blood indexes such as 24-hour urine protein,and the factors with statistical significance in each group were included in the multivariate non-conditional Logistic regression analysis.Results:1.The general situation: data in this study have children with HSP 112 cases,male 69 cases(61.6%),43 patients(38.4%),female sex ratio was 1.6:1.0,minimum 3 years old children,so much 14 years old,the average onset age(8.38 3.06)among them,45 cases of children with gastrointestinal bleeding,men and 28 cases(62.2%),female in 17 cases(37.8%),the incidence of gastrointestinal bleeding is 40.2%,have disease of digestive tract bleeding occurred in 2 weeks in 36 cases(80%).2.Clinical manifestations: among the 112 children with HSP included in the study,there was a rash and purpura manifestation(100%).There were 45 cases(40.2%)with abdominal pain and 57 cases(50.9%)with joint symptoms.There were 47 cases of vomiting(42%)and 9 cases of edema(8.04%).3.Univariate analysis of clinical risk factors related to gastrointestinal hemorrhage in children with HSP: counting data were analyzed by chi-square test and the results showed that: the range of rash distribution,and vomiting was compared between the two groups,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference between the two groups in the cause of seasonal onset,gender and age,incentive,joint swelling,and pain edema and abdominal pain,CRP,D-dimer,24 hours urinary protein positive(P>0.05).The measurement data was tested by t test,and the results showed that: the absolute value of neutrophil PLT NLR PCT was statistically significant between the two groups(P<0.05).and HB lymphocyte absolute value PDW PLR MPV Fbg no statistical significance between two groups(P > 0.05).4.In multi-factor unconditioned Logistic regression analysis:The choice in the single factor analysis statistically significant factors line and unconditioned Logistic regression analysis,the results showed that the rash distribution,NLR PCT is HSP children independent clinical risk factors for gastrointestinal bleeding.Conclusion:1.The incidence of HSP gastrointestinal bleeding in children is 40.2%,and the incidence peak is within 2 weeks after onset,which needs to be closely monitored.2.Vomiting symptoms,increased white blood cells,increased neutrophil absolute count,and increased platelets may be related to the occurrence of gastrointestinal bleeding caused by HSP.3.Range of rash distribution,NLR,PCT may be an independent clinical risk factors for digestive tract hemorrhage in children with HSP.Therefore,children with HSP with the above risk factors should be closely monitored in order to detect the occurrence of digestive tract hemorrhage at an early stage and provide a basis for clinical treatment.