| Objective:The clinical characteristics and laboratory data of 1817 Henoch-Schonlein Purpura inpatients（less than or equal to 16 years old）in the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2020 were systematically collected and counted,which gave a profound understanding,study and research of the disease to provide a clinical basis for timely diagnosis,effective treatment and improving the prognosis of Henoch-Schonlein Purpura actively.Methods:The data and information of 1817 cases of anaphylactoid purpura diagnosed in the pediatric department of our hospital from January 2016 to December 2020 were entered using Excel software,and the statistical software Statistical Product and Service Solutions 23.0 was used for retrospective analysis.Grouping:1.According to the age at onset of the children,they are divided into infant group（age less than or equal to 3 years old）,preschool group（age over 3 years old and less than 6 years old）,school-age group（age greater than or equal to 6 years old and less than or equal to 12 years old）,adolescent group（age over 12 years old and less than or equal to 16 years old）.2.According to the presence or absence of j oint,digestive tract and kidney involvement,they were divided into joint involvement group and no joint involvement group,digestive tract involvement group and no digestive tract involvement group,kidney involvement group（Henoch-Schonlein purpura nephritis）and no kidney involvement group.3.According to 25-hydroxyvitamin D3 deficiency,the patients were divided into 25hydroxyvitamin D3 deficiency group and non-25-hydroxyvitamin D3 deficiency group.4.According to whether the kidney involvement group was complicated with streptococcus infection,the patients were divided into Henoch-Schonlein purpura nephritis with streptococcal infection group and Henoch-Schonlein purpura nephritis without streptococcal infection group.According to the above groupings,the differences in clinical manifestations and laboratory test results between the groups were compared,and P<0.05 indicated statistical significance.Results:1.There is a statistical difference in the incidence of Henoch-Schonlein purpura by gender;the incidence rate of boys is higher than that of girls after childhood;the peak incidence period is 6-12 years old;male children with Henoch-Schonlein purpura are more likely to involve the kidneys;age>6 years old is a risk factor for renal involvement in children with Henoch-Schonlein purpura.2.Infection is the most common cause of the disease,especially respiratory infection（23.67%）.There is a strong positive linear correlation between the number of children with Henoch-Schonlein purpura and the number of concurrent respiratory infections in each month.Food as a cause of the disease exists but is rare,accounting for only 1.38%.3.There is a statistical difference between the seasons of the disease,and the incidence in autumn and winter is significantly higher than that in spring and summer.From 2016 to 2020,the number of cases in each month has a similar trend,and the number of cases in summer is the least every year,which is significantly less than that in spring,autumn and winter.4.The lower extremities are the most easily affected parts of the rash,followed by the buttocks and upper extremities.It is rare to involve the trunk,head and face.In all children,only the lower extremities were the most common rash manifestations,followed by involving both the lower extremities and buttocks.The rash is generally symmetrical in distribution.5.There were 435 children with joint involvement in the course of the disease.The ankle joint of the lower extremity is the most vulnerable site,followed by the knee joint.Among all the manifestations of joint involvement in children,only the ankle joint was the most common,followed by the joint involvement of the ankle and knee joints.Patients with 25-hydroxyvitamin D3 deficiency,streptococcal infection,or kidney damage are more likely to involve the joints.There was a statistically significant difference in immunoglobulin G between the joint-involved group and the non-joint-involved group.6.There were 485 cases involving the digestive tract during the course of the disease.Abdominal pain was the most common presentation,followed by vomiting.Of all the manifestations involving the gastrointestinal tract,only abdominal pain was the most common,followed by abdominal pain with vomiting.Of all the results of gastroscopy due to abdominal pain and gastrointestinal bleeding,the descending duodenum was most likely to be involved,followed by the duodenal bulb.Patients with mycoplasma infection,helicobacter pylori infection,or respiratory infection are more likely to involve the digestive tract.Fibrinogen degradation products,D-dimer,and complement C3 were statistically different between the gastrointestinal involvement group and nongastrointestinal involvement group.7.There was 404 patient with renal involvement.Patients with 25-hydroxyvitamin D3 deficiency,respiratory tract infection,streptococcal infection,helicobacter pylori infection,mycoplasma infection,3 or more rash sites,j oint symptoms or gastrointestinal symptoms are more likely to involve the kidneys.Monocytes,basophils,fibrinogen degradation products,D-dimer,complement C3,and immunoglobulin G were statistically different between the renal involvement group and non-renal involvement group8.The levels of immunoglobulin G,immunoglobulin A,immunoglobulin M,globulin and alkaline phosphatase in the Henoch-Schonlein purpura nephritis group with streptococcus infection were higher than those in the Henoch-Schonlein purpura nephritis without streptococcal infection group.The difference was statistically significant（PIgG<0.001,PIgA<0.001,PIgM=0.003,PGLO<0.001,PALP=0.036）.The complement C3,complement C4 and glomerular filtration rate in the Henoch-Schonlein purpura nephritis group with streptococcus infection were lower than those in the Henoch-Schonlein purpura nephritis group without streptococcal infection,and the difference was statistically significant（PC3=0.016,PC4=0.002,PeGFR=0.039）.Conclusion:1.The incidence of Henoch-Schonlein purpura is higher in boys than in girls.The peak incidence period is 6-12 years old.Autumn and winter are the high incidence seasons.Respiratory tract infection is an important cause of the disease.Although the proportion of food as an incentive is low,it cannot be ignored.Male is a risk factor for renal involvement and 25-hydroxyvitamin D3 deficiency in children with Henoch-Schonlein purpura.Age≥6 years is a risk factor for renal involvement in children with HenochSchonlein purpura.2.Streptococcus infection is a risk factor for joint and kidney involvement;Mycoplasma infection is a risk factor for digestive tract and kidney involvement;Helicobacter pylori infection is a risk factor for digestive tract and kidney involvement;Combining with 25hydroxyvitamin D3 deficiency is a risk factor for joint and kidney involvement;respiratory infection is a risk factor for j oint,digestive tract and kidney involvement;more than or equal to 3 rash sites,digestive tract symptoms or joint symptoms are risk factors for kidney involvement.3.Immunoglobulin G disorder may play an important role in joint and kidney involvement,and D-dimer may play a role in digestive tract and kidney involvement.4.The Henoch-Schonlein purpura nephritis with streptococcal infection group has higher immunoglobulins and more severe hypocomplementemia than the Henoch-Schonlein purpura nephritis without streptococcal infection group.Hypocomplementemia is a bridge between streptococcal infection and kidney damage. |
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