Department of Pediatrics, Yantaishan Hospital, Yantai, Shandong, China.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(17):3894-3899.
To investigate risk factors related to kidney injury in children with Henoch-Schonlein purpura (HSP) and to study the therapeutic effects of hemoperfusion (HP) on kidney injury in HSP children, providing clinical evidence for early prevention and treatment of HSP.
Children who suffered from HSP for the first time were selected as study objects and they were followed up for 12 months. Single factor analysis and multi-factor Logistic regression analysis were performed for children's demographic characteristics (age, gender), clinical manifestations (rash duration time, rash recurrence times, digestive tract hemorrhage, abdominal pain, arthralgia, HSP recurrence) and laboratory indexes (peripheral blood WBC, PLT, ESR, CRP, serum IgG, serum IgA, IgM, serum C3, serum C4, TC, TG, HDL, LDL). Meanwhile, participants were divided into treatment group (HP treatment) and control group, and the protective effects of HP on renal function of HSP children were discussed.
Single factor analysis indicated age ≥ 6 years, rash recurrence ≥ 3 times, rash duration time ≥ 1 month, digestive tract hemorrhage, peripheral blood PLT, WBC, serum TC and serum LDL levels had statistically significant differences between the two groups. Multi-factor Logistic regression analysis indicated rash recurrence ≥ 3 times, digestive tract hemorrhage, decline of peripheral blood PLT count, and increases of serum TC and LDL were closely related to kidney injury of HSP children. After discharge, kidney injury comparison between treatment group and control group in follow-up had a statistical difference.
Rash recurrence ≥ 3 times, digestive tract hemorrhage, decline in peripheral blood PLT count, increases of serum TC and LDL, are risk factors of kidney injury in HSP children. HP can protect renal function of HSP children.
探讨儿童过敏性紫癜（HSP）并发肾损伤的相关危险因素，并研究血液灌流（HP）对 HSP 患儿肾损伤的治疗效果，为 HSP 的早期防治提供临床依据。
选取首次发生 HSP 的患儿作为研究对象，进行 12 个月的随访。对患儿的一般资料（年龄、性别）、临床表现（皮疹持续时间、皮疹复发次数、消化道出血、腹痛、关节痛、HSP 复发）和实验室指标（外周血白细胞、血小板、红细胞沉降率、C 反应蛋白、血清 IgG、血清 IgA、IgM、血清 C3、血清 C4、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白）进行单因素分析和多因素 Logistic 回归分析。同时将患儿分为治疗组（HP 治疗）和对照组，探讨 HP 对 HSP 患儿肾功能的保护作用。
单因素分析显示，两组间年龄≥6 岁、皮疹复发≥3 次、皮疹持续时间≥1 个月、消化道出血、外周血血小板、白细胞、血清总胆固醇、血清低密度脂蛋白水平比较，差异有统计学意义（P<0.05）。多因素 Logistic 回归分析显示，皮疹复发≥3 次、消化道出血、外周血血小板计数下降、血清总胆固醇和 LDL 升高与 HSP 患儿肾损伤密切相关。出院后，治疗组与对照组在随访中肾脏损伤比较差异有统计学意义。
皮疹复发≥3 次、消化道出血、外周血血小板计数下降、血清总胆固醇和 LDL 升高是 HSP 患儿发生肾损伤的危险因素。HP 能保护 HSP 患儿的肾功能。
