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目的 了解小儿过敏性紫癜 (AP)的少见器官———心、肝、肺、脑损害的临床特点。方法 分析73例具有心、肝、肺、脑损害的临床和实验室资料。结果 全部病例均有典型皮肤紫癜 ,并伴疾病开始或病程早期神经血管性水肿和荨麻疹 14例 (19 2 % ) ;73例中病程早期发现 :①心脏改变 43例 (5 8 9% ) ,包括心悸、心尖部杂音等症状、体征 2 0例 ,心电图异常 2 4例 ,心肌酶升高 11例。②触诊及超声波检查肝大 18例(2 4 7% ) ,肝功障碍 7例。③肺受累 17例 (2 3 3% ) ,咳嗽及肺内干湿性罗音等症状、体征 17例 ,胸部X线检查表现为肺炎 8例 ,支气管炎 6例 ,胸膜炎 2例 ,肺水肿 1例。④脑受累 8例 (11% ) ,有头痛等症状 9例 ,脑电图中度以上异常 8例 ;依次与胃肠道、关节和肾脏共同受累形成符合多器官损害的严重病例占 94 5 % ,损害器官越多越严重 ,心、肝、肺、脑受累机会越大 ;经对比分析 73例少见器官受累率汉族病儿比蒙古族高 (P <0 0 5 ) ;经治疗后心、肝、肺、脑损害与神经血管性水肿和荨麻疹一起随着皮肤紫癜的消退而迅速减轻或消失。结论 小儿AP有心、肝、肺、脑受损 ,并见于病程早期和多器官损害的重症病例中 ,可作为早期发现重症的线索 ,及时治疗预后良好。推测其发病可能和Ⅰ型变态反应有关。汉族病儿少
Objective To understand the clinical features of rare organs in children with Henoch-Schonlein purpura (AP), such as heart, liver, lung and brain damage. Methods 73 cases of clinical and laboratory data with heart, liver, lung and brain damage were analyzed. Results All the cases had typical skin purpura accompanied by 14 cases (19.2%) of neurovascular edema and urticaria at the beginning or early course of the disease. The early stage of the course of the disease was found in 73 cases (43 cases, 589%), Including palpitations, apical murmur and other symptoms, signs of 20 cases, 24 cases of abnormal ECG, myocardial enzymes increased in 11 cases. ② palpation and ultrasound examination in 18 cases of hepatomegaly (24.7%), liver dysfunction in 7 cases. ③ There were 17 cases (23.3%) of lung involvement, 17 cases of symptoms such as cough and dry rales of the lung, chest X-ray examination of 8 cases of pneumonia, 6 cases of bronchitis, 2 cases of pleurisy and 1 case of pulmonary edema example. ④ brain involvement in 8 cases (11%), headache and other symptoms in 9 cases, moderate and severe EEG in 8 cases; followed by the gastrointestinal tract, joint and kidney were involved in the formation of multiple organ damage accounted for 94.5% , The more damage the organ more the more serious, the heart, liver, lung, brain involvement opportunities; comparative analysis of 73 cases of rare organ involvement Han children than Mongolian children (P <0 05); after treatment of heart and liver , Lung, brain damage and neurovascular edema and urticaria with the skin purpura fade and quickly reduce or disappear. Conclusions The AP in children with heart, liver, lung and brain damage, and found in the early course of disease and multiple organ damage in severe cases, can be used as early detection of severe clues, timely treatment of good prognosis. Presumably its incidence may be related to type Ⅰ allergy. Han sick children less