摘要
背景:成人过敏性紫癜(HSP)少见,以消化道症状为首发表现时较易误诊。目的:分析成人腹型HSP的临床、内镜特征和治疗方法,以提高该病的早期诊断和治疗水平。方法:2005年1月～2010年12月于北京友谊医院确诊为"腹型紫癜"的22例成人患者纳入研究,对其临床资料进行回顾性分析。结果:本组成人腹型HSP患者以青年为主,14例(63.6%)有明显发病诱因。所有患者均出现皮肤紫癜伴腹痛,多数患者腹痛程度与腹部体征不相符,7例(31.8%)患者腹痛先于皮肤紫癜出现,18例(81.8%)患者有消化道出血表现(显性出血7例,隐血11例)。内镜检查见病变主要累及小肠,病变黏膜散在鲜红色或暗红色出血斑,伴糜烂、浅溃疡。21例患者接受糖皮质激素治疗,激素治疗后腹痛、消化道出血明显缓解。结论:了解成人腹型HSP的临床和内镜特征有助于提高首诊诊断率。激素治疗对腹型HSP的消化道症状有效。
Baekgrund： Henoeh-Sehonlein purpura （lISP） is uncommon in adults and easily to be misdiagnosed when abdominal symptoms precede cutaneous lesions. Aims： To analyze the clinical and endoscopic eharaeteristics, and treatment modalities of adult HSP with gastrointestinal involvement for improving the early diagnosis and treatment of the disease. Methods： A retrospeetive study was conducted in 22 adult HSP patients with gastrointestinal involvement enrolled from Jan. 2005 to Dee. 2010 at Beijing Friendship Hospital. Results： Adult HSP patients with gastrointestinal involvement enrolled in this study were mainly youth, and 14 patients （63.6%） had obvious indueing causes. All of the patients had cutaneous purpura and abdominal pain, and the severity of abdominal pain was not concordant with physical signs in most patients. Abdominal pain occurred prior to eutaneous purpura in 7 patients （31.8%）, and 18 patients （81.8%） had gastrointestinal bleeding （7 overt bleeding and 11 occult bleeding）. Endoscopieally, gastrointestinal lesions involved mainly small intestine, the findings included multiple scattered bright or dull red mucosal hemorrhagic plaques with erosions and superficial uleem. Glueoeorticoids were administered in 21 patients and significant relief of abdominal pain and bleeding was obtained. Conclusions： Familiar with the clinical and endoscopic characteristics of adult HSP with gastrointestinal involvement is essential for the early and accurate diagnosis of the disease, and steroids are effective for the relief of abdominal symptoms.
出处
《胃肠病学》
2011年第11期676-678,共3页
Chinese Journal of Gastroenterology
关键词
紫癜
过敏性
成年人
腹痛
胃肠出血
症状和体征
内镜检查
消化系统
Purpura, Schoenlein-Henoch
Adult
Abdominal Pain
Gastrointestinal Hemorrhage
Symptoms ＆ Signs
Endoscopy, Digestive System
