Study on risk factors of recurrent Henoch-Schonlein purpura recurrence in children based on Cox regression analysis

Kaili Zhu; Yanping Huang; Li Liu; Ning Wang; Jin Wang

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Study on risk factors of recurrent Henoch-Schonlein purpura recurrence in children based on Cox regression analysis

VernacularTitle:基于Cox回归分析的儿童过敏性紫癜复发危险因素研究
Author: Kaili ZHU ^{1
,

2} ; Yanping HUANG ¹ ; Li LIU ¹ ; Ning WANG ³ ; Jin WANG ⁴
Author Information

1. Department of Pediatrics, The First AffIliated Hospital of Xi’an Jiaotong University, Xi’an 710061
2. Department of Pediatrics, Xi’an No.3 Hospital, Xi’an 710021
3. Department of Pediatrics, Xi’an International Medical Center Hospital, Xi’an 710100
4. Department of Pediatrics, Lintong Maternal and Child Health, Xi’an 710699, China
Publication Type:Journal Article
Keywords: Henoch-Schonlein purpura; risk factors for recurrence; child; Cox regression analysis
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(2):283-287
CountryChina
Language:Chinese
Abstract: 【Objective】 To explore the relevant risk factors of Henoch-Schonlein purpura (HSP) recurrence so as to provide some theoretical basis for early identification of children prone to recurrence. 【Methods】 The clinical data of 417 children with HSP hospitalized in Department of Pediatrics, The First Affiliated Hospital of Xi’an Jiaotong University, in the past five years were collected and followed up. They were divided into recurrent group and non-recurrent group. Cox regression analysis was used for univariate and multivariate analysis, and finally the independent risk factors for HSP recurrence were screened. 【Results】 A total of 417 children with initial onset of HSP were included in the study. During the follow-up period of 14 to 60 months, 78 cases recurred, and the recurrence rate was 18.7%. 94.9% of the children had relapse within 1 year. The results of univariate Cox regression analysis showed that age >7 years old at the time of onset, history of infection, history of strenuous exercise, duration of rashes more than 4 weeks, high level of neutrophil-to-lymphocyte ratio (NLR), and high level of platelet-to-lymphocyte ratio (PLR) were all risk factors for HSP recurrence (P<0.05). The prolongation of activated partial thromboplastin time (APTT) was the protective factor for HSP recurrence (P<0.05). Multivariate Cox regression analysis showed that age >7 years old at the time of onset, history of infection, history of strenuous exercise, duration of rashes for more than 4 weeks at the first onset, and high PLR level were independent risk factors for HSP recurrence (P<0.05). 【Conclusion】 The recurrence rate of HSP was 18.7%, and 94.9% of the recurrent children had HSP recurrence within 1 year. Therefore, children with HSP should be followed up for at least one year. For children aged > 7 years at the time of onset, with a history of infection, vigorous exercise, rashes lasting more than 4 weeks, and high PLR level, nursing should be strengthened after discharge to avoid infection and vigorous exercise and increase the frequency of follow-up.