| Abstract:Objective:To understand the characteristics of Henoch-Schonlein purpura s (HSP s) morbility and provide reference to the clinical diagnosis,prevention and treatment through analyzing the clinical characteristics of the patients with HSP.Methods:①142 patients with HSP from the department of dermatology in the Affiliated Hospital of Luzhou Medical College from July in 2008 to July in 2009 were analyzed retrospectively.The patients were divided into groups according to the age,the season of morbility and the type.The age,gender,attack seasons, inducement,clinical manifestation,organs involved in the recurring patients,laboratory examinations including the 3 routine examination,IgE antibodies against allergens,specific IgG antibodies against food and CD4+CD25+ regulatory T cells(Tregs),and prognosis were recorded and analyzed.②SPSS10.0 software was used to analyze the dataχ2 test was used to analyze the enumeration data,t test used for the measurement data.It had statistical difference when P<0.05.Results:①The epide-miological data:ⅰ.The ratio of male to female was 1.02:1,which had no statistical difference(P=0.933).89 patients in the impuberism group were statistically more than 53 in the adult one(P=0.003).ⅱ.The percentage of the patients attacked in spring and winter was 61.97%, statistically higher than in summer and winter(χ2=8.141,P=0.004).In the impuberism group, the percentage of the patients attacked in spring and winter was 65.17%, statistically higher than 56.60% in summer and winter(χ2=8.909, P=0.003).iii.In 142 patients,59 had no obvious inducements and 83 had.The difference between them was statistically significant(χ2=4.056, P=0.044). The ratio of infection was the highest,followed by food.The inducements of the impuberism and adult group weren’t statistically different(P>0.05).②The clinical data:ⅰ.The ratio of the patients with gastrointestinal symptoms in the impuberism group was statistically higher than in the adult one,while the ratio of these with kidney symptoms lower than in the adult(P<0.05).The difference of patients with skin purpura only,affiliated arthral symptoms and affiliated multi-organ symptoms wasn’t statistically significant(P>0.05).There was statistical difference among each type(χ2=18.07,P=0.001). ii.Among all patients,these with ascarides in the intestinal tract,with pero-bowl obstruction and ascetic fluid were 2,respectively,1 with chordapsus induced by staphylococcal infection,1 with varicella,1 with infective cardiomyopathy and 1 with ureteral calculus and laevus hydronephrosis.ⅲ.Among 51 relapse patients,24 (26.97%) in the impuberism group were statistically different from 27(50.94%) in the adult(χ2=8.297,P=0.004).Only the ratio of the recurring patients with mixed type in both groups was statistically different(χ2=3.968,P=0.046).The remaining types in 2 groups showed no significant difference((P>0.05).③The general tests:ⅰ.81 patients WBC increased,including 56 in the impuberism group and 25 in the adult,without statistical difference(χ2=3.36,P=0.067).32 patients PLT increased,and 28(31.46%) were in the impuberism group,higher statistically than in the adult(χ2=10.882,P=0.001).ⅱ.66(46.48%) patients’urine was abnormal,30 in the impuberism group different statistically from 36 in the adult(χ2=15.643,P< 0.001).The positive ratio of albuminuria and hematuria in the impuberism group was statistically lower than in the adult(χ2=12.535,P<0.001).12 patients with suspective albuminuria were tested the small proteins in the urine,and 7(58.33%) were positive.ⅲ.40 patients with gatrointestinal symptoms underwent stool examination,stool occultblood positive in 18 cases(45.00%).④The laboratory research:ⅰThe test of IgE antibodies against allergens and specific IgG antibodies against food:1)Among 75 patients with HSP tested IgE antibodies against allergens in serum,41(54.67%) showed positive IgE antibodies against inhaled allergens,and 45(60.00%) against food allergens.The positive rate of dermatophagoides culinaes in the inhaled allergens was the highest,followed by the fur scrap of cats and dogs(χ2=20.317,P=0.001).The top 3 food allergens were shrimps,crabs, eggs, beans and peanuts(χ2=66.6, P<0.001).59(78.67%) patients showed more than one kind of IgE antibodies.2)The test of the specific IgG antibodies against food:Among 30 patients tested the specific IgG antibodies against food,28(93.33%) showed positive,and 22(73.33%) had more than 1 kind.The top 4 food allergens were eggs(56.67%), milk(33.33%), shrimps(30.00%)and crabs (20.00%) (χ2=39.316,P<0.001).ⅱ.The test of CD4+CD25+Tregs:The percentage of CD4+CD25+ Tregs in 20 patients peripheral blood was (4.93±1.70)%,statistically lower than of the control group(8.66±1.98)% (t=27.86,P<0.001).⑤Prognosis:The average stay of 142 patients with HSP was (10.15±4.55)d.The average stay of the impuberism group was (9.08±4.67)d,statistically less than the adult group(10.68±4.36) d (t=2.023, P<0.05).The cure and improvement rate was 56.34% and 39.44%, respectively.And the prognosis of both groups was not statistically different(P>0.05). Conclusion:①HSP mostly occurred in adults and in spring and winter.The supreme inducement might be infection.Food was the second, and eggs,shrimps,crabs and milk were common.The results showed anti-inflammatory,fasting diet and rotation therapy is significant.②The mixed type was the most common,with the most recidivists.And adults were more prone to recurrence than minorities.The patients with gastrointestinal symptoms were common in the minorities,while kidney symptoms in the adults.③Some patients with HSP showed transient increase of platelet count,especially in minorities,which illustrated anticoagulant therapy is necessary.Adults with HSP were prone to urine abnormality, often with Hematuria and proteinuria.④The percentage of CD4+CD25+regulatory T cells in the peripheral blood of the patients with HSP in the acute phase was lower than of the healthy people,which showed the decrease of CD4+CD25+ regulatory T cells might be related to HSP. |
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