糖皮质激素治疗藏族儿童过敏性紫癜的疗效分析

Xiangyun Zhang, Zha-Ba Nima, Shu-ning Zhang, Wangdui Suona, Ciren Pubu, Shengyou Yu
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引用次数: 2

摘要

背景:过敏性紫癜(HSP)是儿童常见的免疫相关过敏性疾病。了解本病的临床特点对医生来说非常重要。目的:探讨糖皮质激素治疗高原藏族儿童热休克的临床疗效,并分析高原藏族儿童热休克的可能原因。该疾病的危险因素为高海拔地区儿童热休克的治疗提供参考。方法:选取2015年1月至2020年11月在西藏自治区波密县人民医院门诊部和住房部诊断为过敏性紫癜的88例患儿为研究对象。对其性别、发病年龄、发病季节、易感因素、过敏史、首发症状、临床表现、实验室检查等进行回顾性分析。结果:88例过敏性紫癜患儿中,男孩55例,占62.5%;女孩33例,占37.5%。男性的病例比女性多。均有皮肤紫癜的临床表现,其中有明显诱因35例,其中呼吸道感染26例,饮食因素6例,接触过敏物质3例。单纯性皮肤型:18例,占20.45%;腹部型:6例,占6.82%;男性2例,占33.33%;女性4例,占66.67%;关节型:8例,占33.33%;肾型:2例,占2.27%;混合型54例,占61.36%。经糖皮质激素治疗后,皮疹消失,无不良反应。结论:儿童过敏性紫癜多见于学龄儿童,上呼吸道感染是主要易感因素。皮肤紫癜是主要的临床表现,常伴有下肢关节肿胀和疼痛。静脉与口服治疗在疗效和病程上无显著差异。因此,临床医生应严格掌握糖皮质激素的适应症,以减少并发症的发生。
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Efficacy Analysis of Glucocorticoids in the Treatment of Allergic Purpura in Tibetan Children
Background: Henoch Schonlein Purpura (HSP) is a common immune-related allergic disease in children. It is very important to understand the clinical features of this disease for doctors. Objective: To explore the clinical efficacy of glucocorticoids in the treatment of HSP in Tibetan children at high altitude, and to analyze the possible causes of HSP in children at high altitude. The risk factors of the disease provide a reference for the treatment of HSP in children in high altitude areas. Methods: Selecting January 2015 to November 2020, 88 children diagnosed with Henoch-Schonlein Purpura in the outpatient and inpatient departments of the People’s Hospital of Bomi County, Tibet Autonomous Region were the subjects of the study. Its gender, age of onset, season of onset, predisposing factors, allergy history, first symptoms, clinical manifestations, laboratory examinations, etc., perform retrospective analysis. Results: Among 88 children with allergic purpura, 55 were boys, accounting for 62.5%, and 33 were girls, accounting for 37.5%. Men have more cases than women. All have clinical manifestations of purpura of the skin, among which 35 cases have obvious triggers, of which the above there were 26 cases of respiratory infections, 6 cases of dietary factors, and 3 cases of contact with allergic substances. Simple skin type: 18 cases, accounting for 20.45%; Abdominal type: 6 cases, accounting for 6.82%; 2 male cases, accounting for 33.33%; 4 female cases, accounting for 66.67%; Articular type: 8 cases, accounting for 33.33%; Renal type: 2 cases, accounting for 2.27%; 54 cases of mixed type, accounting for 61.36%. After glucocorticoids, the rashes disappeared, no any adverse reactions. Conclusion: Allergic purpura in children is more common in school-age children, and upper respiratory tract infection is the main predisposing factor. Skin purpura is the main clinical manifestation, often associated with lower extremity joint swelling and pain. There is no significant difference in the efficacy and course of the disease between intravenous and oral treatment. Therefore, clinicians should strictly grasp the indications of glucocorticoids to reduce the occurrence of complications.
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