儿童期过敏性紫癜性肾炎自限性尿液异常的临床预测指标

• 作 者: Hung S.-H. Lee C.-C. B.-L.Chiang 张振
• 机 构: Department of Paediatrics National Taiwan University Hospital,National Taiwan University,7 Chung-Sha
• 出 处: 世界核心医学期刊文摘(儿科学分册)
• 发表日期: 2006年08期
• 关键词: 自限性 临床预测 童期 尿液 台湾大学 单变量分析 预后指标 阳性预测值 发病年龄 病程

Background and aim:The majority of patients(85-95%)with Henoch-Schnlein purpura nephritis(HSPN)suffer froma prolonged course of urinalysis abnormality.We sought to identify favourable prognostic factors predicting a self-limited urinalysis abnormality within 1 y.Methods:Fifty-eight HSPN patients admitted to the University Hospital between 1990 and 2003 were retrospectively analysed.Detailed information on clinical and laboratory manifestations on admission and sequential follow-up clinics were recorded.The χ2 or Fisher’s exact test were used for univariate analysis,and multiple logistic regression was used for multivariate analysis.Results:The study cohort included 31 boys and 27 girls,with a mean age of onset of 8.0±4.3 y and a median follow-up duration of 5.9 y(range 1 to 25).Of 58 patients,39(67.3%)had a self-limited urinalysis abnormality within 1 y.On multivariate analysis,onset age less than 9(p =0.038),low-grade proteinuria(p =0.044)and interval between purpura onset and renal manifestations less than 2 wk(p =0.005)predicted self-resolved urinalysis abnormality within 1 y.With two or more predictive factors,the sensitivity for short-term course was 84.6%,the specificity was 73.7%,and the positive predictive value was 84.8%.Conclusion:A small number of variables were important for detecting a favourable short-term course of urinalysis abnormality.

Background and aim: The majority of patients (85-95%) with Henoch-Schnlein purpura nephritis (HSPN) suffer froma prolonged course of urinalysis abnormality. We sought to identify favoura prognostic factors predicting a self-limited urinalysis abnormality within 1 y . Methods: Fifty-eight HSPN patients admitted to the University Hospital between 1990 and 2003 were retrospectively analyzed. Detailed information on clinical and laboratory manifestations on admission and sequential follow-up clinics were recorded. Χ2 or Fisher’s exact test were used for univariate analysis , and multiple logistic regression was used for multivariate analysis. Results: The study cohort included 31 boys and 27 girls, with a mean age of onset of 8.0 ± 4.3 y and a median follow-up duration of 5.9 y (range 1 to 25) .Of 58 patients, 39 (67.3%) had a self-limited urinalysis abnormality within 1 y. On multivariate analysis, onset age less than 9 (p = 0.038), low- grade proteinuria and re nal manifestations less than 2 wk (p = 0.005) predicted self-resolved urinalysis abnormality within 1 y.With two or more predictive factors, the sensitivity for short-term course was 84.6%, the specificity was 73.7%, and the positive predictive value was 84.8% .Conclusion: A small number of variables were important for detecting a favourable short-term course of urinalysis abnormality.