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目的总结以急性胰腺炎为首发表现的过敏性紫癜的临床特点。方法对中国医科大学附属第一医院1997—2005年期间收治的5例以急性胰腺炎为首发表现的过敏性紫癜病例的临床资料进行回顾性分析。结果本组5例患者年龄均在17～28岁。所有患者均有腹痛症状,均有上腹部压痛,但无肌紧张,仅1例患者有反跳痛。伴呕吐4例。5例患者均出现血清淀粉酶和尿淀粉酶升高,2例超声检查见胰腺体积增大。典型的四肢皮肤紫癜出现于发病后的第4～8天。结论以急性胰腺炎为首发表现的过敏性紫癜多发生在青少年患者中,临床上对无胆道疾病、饮酒、暴饮暴食等明确病因的急性胰腺炎患者,应注意动态观察有无典型的四肢皮肤紫癜出现,以便及早对原发病作出正确的诊断和治疗。
Objective To summarize the clinical features of allergic purpura with acute pancreatitis as the first manifestation. Methods The clinical data of 5 cases of allergic purpura with acute pancreatitis as the first manifestation were retrospectively analyzed in the First Affiliated Hospital of China Medical University from 1997 to 2005. Results The 5 patients in this group were 17 to 28 years of age. All patients had symptoms of abdominal pain, both had tenderness on the abdomen, but no muscle tension, only 1 patient had rebound pain. With vomiting in 4 cases. Serum amylase and urinary amylase were elevated in all 5 patients. Pancreatic volume increased in 2 patients undergoing ultrasound. Purpura typical of extremities appear in the first 4 to 8 days after onset. Conclusion Acute pancreatitis as the first manifestation of allergic purpura occurred in adolescents, clinically for patients with no clear biliary disease, alcohol, overeating and other clear causes of acute pancreatitis should pay attention to dynamic observation with or without typical limb skin Purpura appears, in order to make the correct diagnosis and treatment of the primary disease as soon as possible.