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目的 探讨过敏性紫癜复发及影响其预后的临床因素。方法 对随访资料完整的 36例过敏性紫癜患儿进行回顾性分析。结果 痊愈 34例 ,迁延未愈 2例。 36例中有反复、迁延者 2 0例 (5 5 6 % ) ,其中皮肤紫癜反复 17例 ,血尿、蛋白尿反复 3例。反复诱因中上呼吸道感染占 4 5 % ,接触过敏原占 30 % ,不明原因占2 5 % ;反复、迁延患儿血清IgA增高及CD4 /CD8比值降低例数明显高于非反复患儿 ,有显著统计学意义 (P <0 0 5 ,P <0 0 1)。结论 过敏性紫癜反复、迁延与上呼吸道感染、反复接触过敏原有关 ;地塞米松、氢化可的松治疗对控制腹痛、胃肠道出血、关节疼痛有较好疗效 ,对防止皮肤紫癜反复及肾累及无效 ,甲基泼尼松龙冲击治疗和间歇白细胞去除术对紫癜性肾炎有效 ;免疫调节治疗有可能减少复发。
Objective To investigate the clinical factors of recurrent allergic purpura and its prognosis. Methods A retrospective analysis was performed on 36 children with Henoch-Schonlein purpura who had complete follow-up data. 34 cases were cured, delayed healing in 2 cases. Of the 36 cases, 20 were repeated (65.6%), including 17 cases of skin purpura, 3 cases of hematuria and proteinuria. Repeated incentives for upper respiratory tract infection accounted for 4.5%, 30% of exposure to allergens, unexplained causes accounted for 25%; repeated and delayed serum IgA in children with increased and CD4 / CD8 ratio decreased significantly higher than non-recurrent children with Significant statistical significance (P <0 05, P <0.01). Conclusions Allergic purpura repeatedly and persistently associated with upper respiratory tract infection and repeated exposure to allergens. Treatment with dexamethasone and hydrocortisone is effective in controlling abdominal pain, gastrointestinal bleeding and joint pain. It is effective in preventing skin purpura repeatedly and in kidney Involving ineffective, methylprednisolone impact therapy and intermittent leukapheresis are effective for purpura nephritis; immunomodulatory therapy may reduce recurrence.