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[儿童与成人荨麻疹的临床特征]

[Clinical characteristics of urticaria in children versus adults].

作者信息

Tang Ni, Mao Man-Yun, Zhai Rui, Chen Xiang, Zhang Jiang-Lin, Zhu Wu, Li Jie

机构信息

Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jul;19(7):790-795. doi: 10.7499/j.issn.1008-8830.2017.07.012.

Abstract

OBJECTIVE

To study the clinical characteristics of urticaria in children versus adults, and to provide reference for the etiological analysis, disease evaluation, and treatment of urticaria in children.

METHODS

The clinical data of 2 411 patients with urticaria who visited the Department of Dermatology at Xiangya Hospital of Central South University from January 2013 to May 2017 were collected to study their socio-demographic characteristics. The clinical characteristics of urticaria were compared between the 68 children and 672 adults of the 740 patients with complete follow-up data.

RESULTS

Among the 411 pediatric patients, 314 (76.4%) had acute urticaria; among the 2 000 adult patients, 896 (44.8%) had chronic spontaneous urticaria. The causes of acute urticaria in children included infection (41%, 16/39). The accompanying symptoms of acute urticaria in children mainly included abdominal pain and diarrhea (44%, 17/39), while those in adults mainly included chest distress and shortness of breath (32%, 11/34). Compared with the adult patients, the pediatric patients had significantly lower chronic urticaria activity scores before and after treatment (P<0.05), a significantly higher rate of response to second-generation antihistamines (82.1% vs 62.2%; P<0.05), and a significantly higher proportion of individuals with a personal and family history of urticaria (P<0.05).

CONCLUSIONS

Acute urticaria is more commonly seen than chronic urticaria in children with urticaria, and the main accompanying symptoms are abdominal pain and diarrhea, which are different from adults with urticaria. Chronic urticaria has a better treatment outcome in children than in adults. The most frequently seen cause of acute urticaria is infection in children. Atopic children may be susceptible to urticaria.

摘要

目的

研究儿童与成人荨麻疹的临床特征,为儿童荨麻疹的病因分析、病情评估及治疗提供参考。

方法

收集2013年1月至2017年5月在中南大学湘雅医院皮肤科就诊的2411例荨麻疹患者的临床资料,分析其社会人口学特征。对740例有完整随访资料的患者中68例儿童和672例成人的荨麻疹临床特征进行比较。

结果

411例儿童患者中,314例(76.4%)为急性荨麻疹;2000例成人患者中,896例(44.8%)为慢性自发性荨麻疹。儿童急性荨麻疹的病因包括感染(41%,16/39)。儿童急性荨麻疹的伴随症状主要为腹痛和腹泻(44%,17/39),而成人主要为胸闷和气短(32%,11/34)。与成人患者相比,儿童患者治疗前后慢性荨麻疹活动评分显著更低(P<0.05),对第二代抗组胺药的反应率显著更高(82.1%对62.2%;P<0.05),有个人及家族荨麻疹病史的个体比例显著更高(P<0.05)。

结论

儿童荨麻疹中急性荨麻疹比慢性荨麻疹更常见,主要伴随症状为腹痛和腹泻,与成人荨麻疹不同。儿童慢性荨麻疹的治疗效果优于成人。儿童急性荨麻疹最常见的病因是感染。特应性儿童可能易患荨麻疹。

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Allergy Asthma Proc. 2016 Jan-Feb;37(1):18-22. doi: 10.2500/aap.2016.37.3915. Epub 2015 Dec 3.
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Current challenges and controversies in the management of chronic spontaneous urticaria.慢性自发性荨麻疹管理中的当前挑战与争议
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