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目的探讨以腹痛和消化道出血为首发症状的过敏性紫癜患者临床表现及内窥镜和影像学特点,为该病的早期诊治提供依据。方法回顾性分析2013年1月-2014年12月本院消化内科收治的50例以腹痛和消化道出血为首发症状的过敏性紫癜患者的临床资料。结果以腹痛最为常见,其次为消化道出血;60.00%患者1周内出现典型的过敏性紫癜皮损,且以腹部剧烈绞痛为主,2周后出现皮损者占12.00%,以轻度腹部隐痛为主,部分患者腹痛与进食的食物密切相关。内窥镜下主要表现为黏膜充血水肿、糜烂、多发点状出血点、散在不规则多发溃疡;影像学主要表现为肠壁肿胀增厚、淋巴结增大。结论该类患者的临床表现及实验室检查结果无特异性,早期诊断困难,但内窥镜下有类似皮肤紫癜的表现,影像学有非特异炎症水肿的表现,这有利于其早期诊治。
Objective To investigate the clinical manifestations and characteristics of endoscopic and radiological features of patients with anaphylactoid purpura, the first symptom of abdominal pain and gastrointestinal bleeding, and provide evidence for the early diagnosis and treatment of this disease. Methods The clinical data of 50 patients with anaphylactoid purpura with abdominal pain and gastrointestinal bleeding as the first symptom were retrospectively analyzed from January 2013 to December 2014 in our hospital. The results of the most common abdominal pain, followed by gastrointestinal bleeding; 60.00% of patients within 1 week typical typical allergic purpura lesions, and severe abdominal cramps, skin lesions occur after 2 weeks accounted for 12.00%, with mild Abdominal pain-based, some patients with abdominal pain and eating food are closely related. Endoscopic mainly manifested mucosal congestion and edema, erosion, multiple punctate bleeding, scattered irregular multiple ulcers; imaging mainly manifested as thickening of the intestinal wall swelling, lymph node enlargement. Conclusion The clinical manifestations and laboratory findings of these patients are nonspecific and difficult to diagnose in the early stage. However, there is a similar appearance of purpura in the endoscope and the non-specific inflammation and edema in the imaging, which is beneficial to its early diagnosis and treatment.