【摘要】 目的:探讨儿童过敏性紫癜(henoch-schonlein purpura,HSP)合并心脏受累的临床特征及危险因素。方法:选取我院2010-01-01～2012-12-30收治的HSP住院患儿873例。总结HSP合并心脏受累患儿的心脏受累时间、临床表现、实验室检查资料及临床转归,分析HSP合并心脏受累可能的相关危险因素,包括性别、年龄、发病前存在诱因、腹痛、关节痛、肾损害情况、幽门螺杆菌感染、C反应蛋白、补体水平等。结果:HSP合并心脏受累患儿221例,占总病例的25.31%,其中男125例,女96例;年龄4～15岁,平均8.5岁;<7岁271例(31.04%),≥7岁602例(68.96%)。其中122例存在心电图异常,主要表现为窦性心动过缓、窦性心动过速、ST-T改变;137例存在心肌酶异常;32例存在X线检查异常;28例存在动态心电图异常;20例存在心脏彩超异常。大多数患儿恢复期内心电图、心肌酶谱、动态心电图、X线检查、心脏彩超随主要症状的消失而恢复正常。结论:HSP患儿,尤其是男性患儿,应注意心脏受累的发生。HSP合并心脏受累主要表现为心肌酶谱、心电图、动态心电图、X线检查、心脏彩超的异常,混合型的HSP合并心脏受累更多见。因此对于HSP合并心脏受累的高危患儿,应早期完善相关检查,以尽早发现和治疗。更多还原

【Abstract】 Objective:To investigate the clinical features and risk factors of henoch-schonlein purpura(HSP)with cardiac involvement.Methods:A total of 873 children with HSP were enrolled,the cardiac involvement time,clinical manifestations,laboratory data and clinical outcomes of children with cardiac involvement were summarized,and the possible risk factors for HSP with cardiac damage,including gender,age,pre-existing predisposition,abdominal pain,joint pain,kidney damage,Helicobacter pylori infection,CRP,complement levels were retro spectively analyzed.Results:There were 221 cases of HSP with cardiac involvement,accounting for 25.31% of the total cases,including 125 males and 96 females,4-15 years old,average 8.5 years old.<7 years old 271 cases(31.04%),≥7 years old 602 cases(68.96%).There were 122 cases with ECG abnormalities,mainly manifested as sinus bradycardia,sinus tachycardia,and ST-T changes.137 cases had myocardial enzyme abnormality.X-ray abnormalities were found in 32 cases.There were 28 cases with abnormal dynamic electrocardiogram.There were 20 cases with abnormal colar Doppler echocardiography.The ECG,myocardial enzyme spectrum,X-ray and color Doppler ultrasound of the heart returned to normal with the disappearance of the main symptoms during the recovery period in most children.Conclusion:Children with HSP,especially male children,should pay attention to the occurrence of cardiac involvement.HSP complicated with cardiac involvement is mainly manifested as abnormal myocardial enzymes,electrocardiogram,dynamic electrocardiogram,X-ray and color Doppler ultrasound.cardiac involvement is more common in mixed HSP.For children with HSP complicated with cardiac involvement who have high risk factors,related inspection should be improved early so as to be found and treated as soon as possible.更多还原