Su Dequan, Yang Mi, Wang Xiaoqin, Li Guangbo, Hong Shaoxian
Department of Nephrology, Xiamen Hospital, Affiliated Children's Hospital of Fudan University (Xiamen Children's Hospital), Xiamen, China.
Department of Immunology and Rheumatology, Fudan University Affiliated Children's Hospital Xiamen Hospital (Xiamen Children's Hospital), Xiamen, China.
Front Pediatr. 2025 Apr 23;13:1587535. doi: 10.3389/fped.2025.1587535. eCollection 2025.
To analyze the risk factors associated with gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura (HSP), with the goal of enhancing early diagnosis and treatment, preventing complications, and improving patient outcomes.
The study involved 23 pediatric patients with HSP who experienced gastrointestinal bleeding, forming the study group. They were admitted to our hospital from June 2023 to June 2024. For comparison, a control group composed of 44 children with HSP but without gastrointestinal bleeding, admitted during the same timeframe, was established. Data on clinical characteristics, laboratory results, and imaging findings were collected. Both univariate and multivariate analyses were conducted to identify potential risk factors.
A total of 67 children with HSP were divided into two groups: those with gastrointestinal bleeding (23 cases) and those without (44 cases). The occurrence of abdominal pain and incidence of intestinal wall thickening detected by gastrointestinal ultrasonography were significantly higher in the group with gastrointestinal bleeding compared to the group without bleeding ( < 0.05). Univariate analysis revealed significant differences in eight laboratory parameters (WBC, NE, NLR, PCT, CRP, D-dimer, Fib, TT), all statistically significant ( < 0.05). Multivariate analysis identified three independent risk factors for gastrointestinal bleeding in children with HSP: abdominal pain (OR = 2.334, 95% CI: 0.458-11.886, = 0.010), a PCT level above 0.12 ng/ml (OR = 10.010, 95% CI: 1.208-82.929, = 0.033), and a D-dimer level exceeding 1.87 mg/L (OR = 3.407, 95% CI: 1.022-17.473, < 0.001).
The findings confirmed that abdominal pain, elevated PCT levels, and increased D-dimer are significant independent risk factors for gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura. Clinicians should monitor these indicators attentively to enhance patient management and outcomes.
分析过敏性紫癜（HSP）患儿发生胃肠道出血的相关危险因素，以提高早期诊断和治疗水平，预防并发症，改善患者预后。
本研究纳入23例发生胃肠道出血的HSP患儿作为研究组，于2023年6月至2024年6月期间收治于我院。为作比较，设立对照组，由同期收治的44例未发生胃肠道出血的HSP患儿组成。收集临床特征、实验室检查结果及影像学检查结果等数据。进行单因素和多因素分析以确定潜在危险因素。
67例HSP患儿共分为两组：发生胃肠道出血组（23例）和未发生胃肠道出血组（44例）。胃肠道出血组腹痛的发生率及胃肠道超声检查发现的肠壁增厚发生率均显著高于未出血组（P<0.05）。单因素分析显示8项实验室指标（白细胞、中性粒细胞、中性粒细胞与淋巴细胞比值、降钙素原、C反应蛋白、D-二聚体、纤维蛋白原、凝血酶时间）存在显著差异，均具有统计学意义（P<0.05）。多因素分析确定了HSP患儿胃肠道出血的3个独立危险因素：腹痛（比值比[OR]=2.334，95%可信区间[CI]：0.458-11.886，P=0.010）、降钙素原水平高于0.12 ng/ml（OR=10.010，95%CI：1.208-82.929，P=0.033）、D-二聚体水平超过1.87 mg/L（OR=3.407，95%CI：1.022-17.473，P<0.001）。
研究结果证实，腹痛、降钙素原水平升高及D-二聚体升高是过敏性紫癜患儿发生胃肠道出血的重要独立危险因素。临床医生应密切监测这些指标，以加强患者管理并改善预后。
