Risk Factors Of Henoch-Schonlein Purpura In Children With Gastrointestinal Damage In Dali District

Objective:To explore the risk factors of gastrointestinal involvement in hospitalized children with Henoch-Schonlein purpura in our hospital,and preliminarily construct the risk prediction model.Methods:The medical records of children with Henoch-Schonlein purpura who were hospitalized in the Fourth People’s Hospital of Yunnan Province from January2018 to December 2020 were collected.According to the inclusion criteria and exclusion criteria,192 cases were screened,and Excel 2016 was used to accurately and detailedly record the data of each child.According to the collected data,192 children with Henoch-Schonlein Purpura were divided into gastrointestinal involvement group and gastrointestinal non-involvement group according to the manifestations of digestive system involvement.The differences in gender,age,nationality,onset season,inducement,clinical characteristics,and laboratory examination between the two groups were compared and analyzed.Count data to choose the number of cases,digestive tract damage group and no digestive tract damage group comparison between the choice of?~2 test.The measurement data are selected to indicate that when the measurement data conform to the normal distribution,the t test of two independent samples is selected for comparison of the differences between groups.If the measurement data do not conform to the normal distribution,the rank-based nonparametric test is selected for comparison.When P<0.05,the difference was statistically significant,stepwise Logistic regression analysis.The predictive model was established according to the results of multivariate Logistic regression analysis,and ROC curve was drawn to evaluate the predictive efficiency of the model.Results:A total of 192 children with Henoch-Schonlein Purpura were included,of which 98 cases(about 51.04%)had gastrointestinal damage.In the single factor analysis,age≥7 years old,lesion range,WBC,NE%,NLR,PLT,ASO,D-D,the difference between groups was significant(P<0.05),with statistical significance,the above indicators and Henoch-Schonlein purpura complicated with gastrointestinal damage was significantly correlated.There was no significant difference in gender,nationality,onset season,joint symptoms,CRP,HGB,HDL,FIB,Ig A,and ESR between the two groups(P>0.05).There was no significant correlation between the above indexes and Henoch-Schonlein purpura complicated with gastrointestinal damage.Further multivariate logistic regression analysis showed that age>7 years(OR=1.025),rash range(OR=1.477),white blood cell count(OR=1.183),neutrophil ratio(OR=1.045),DD dimer(OR=1.483)were independent risk factors for digestive tract damage in children with Henoch-Schonlein Purpura.The established prediction model was Y=age×0.025+rash range×0.390+WBC×0.168+NE%×0.044+D-D×0.394-1.236.AUC was 0.796(95%CI:0.730～0.863).The sensitivity and specificity corresponding to the maximum Youden index were respectively 73.45%and78.48%Conclusion:In children with Henoch-Schonlein purpura in this district,age≥7years old,skin lesions exceeding the lower limbs,WBC increase,NE%increase,and D-D increase are independent risk factors for the above children.The prediction model established in this study has certain reference significance for early prediction and early intervention of allergic purpura and digestive tract damage in children.