摘要
目的 总结腹型过敏性紫癜的临床和内镜特点,以加强对此病的认识。方法 对1994 年1月以来收治的197名过敏性紫癜患者病例资料进行回顾性分析,其中81名为腹型紫癜。19例次 接受了胃镜或肠镜检查。结果 腹型紫癜占紫癜病例的41.1％,其中51例(63.0％)在发病前1-3 周有明确诱因。21例以消化道症状首发,其消化道症状可早于皮损1-40 d出现。74例(91.4％)出 现腹痛,37例(45.7％)表现为消化道出血。内镜表现为胃肠道黏膜弥漫性充血水肿,广泛多发的出 血点、红斑、糜烂、溃疡,小肠病变较重。胃肠道黏膜组织病理学表现为黏膜及黏膜下层中到大量中性 粒细胞浸润、小血管壁纤维素性坏死、灶性出血、糜烂和溃疡。患者的内镜和临床病理表现的范围和 严重程度与消化道症状的程度一致。结论 41.1％的紫癜患者表现为腹型过敏性紫癜,腹型紫癜中 25.9％以消化道症状为首发。小肠病变程度重于胃或结肠。其典型的临床和内镜表现对早期诊断有 一定帮助。
Objective To investigate the clinical and endoscopical features of patients suffered from Henoch-Schonlein purpura (HSP). Methods Retrospective analysis of the clinical manifestation in 197 purpura patients, of which 81 cases were HSP, and described the endoscopic features of 19 cases who underwent gastroscopy and/or colonoscopy. The specimens from 15 cases were evaluated histopathologically. Results Eighty-one patients were diagnosed as HSP, 51 (63. 0% ) of them had a history of upper respiratory tract infection 1 -3 weeks before, taking antibiotics or animal protein prior to the onset of the illness. In 21 patients, abdominal symptoms presented firstly, which occurred 1 -40 days prior to the appearance of skin rashes. Seventy- four (91. 4% ) patients experienced abdominal pain, 37(45. 7% ) patients had digestive tract bleeding. Endoscopic features included diffused congestive edema of gastrointestinal mucosa, widespread hemorrhagic spots, erythema, erosion and ulceration. Lesions were relatively severer in small intestine than those in large intestine. Histological manifestations showed massive neutrophilic infiltration in mucosa and submucosa, fibrotic necrosis of small vessels, focal bleeding, erosion and ulceration. There was prominent accordance in the extents of endoscopic and pathologic manifestation with the severity of gastrointestinal symptoms. Conclusions Forty one percent of purpura patients presented as HSP, of them 26% had the abdominal symptoms firstly. Small bowel lesions were severer than those of stomach or colon. The typical features of the illness and endoscopic findings are very helpful to the early diagnosis of HSP.
出处
《中华消化内镜杂志》
2005年第1期25-28,共4页
Chinese Journal of Digestive Endoscopy
