Analysis of clinical characteristics and risk factors for gastrointestinal bleeding in abdominal Henoch-Schönlein purpura
10.19405/j.cnki.issn1000-1492.2024.12.019
- Author:
Weiping Zhang
1
;
Gang Chen
1
;
Juan Wu
1
;
Jianglong Hong
1
;
Qiao Mei
1
;
Jianming Xu
1
Author Information
1. Dept of Gastroenterology , The First Afiliated Hospital of Anhui Medical University, Hefei 230022
- Publication Type:Journal Article
- Keywords:
abdominal Henoch-Schönlein purpura;
gastrointestinal bleeding;
clinical features;
albumin;
fibrin degradation products
- From:
Acta Universitatis Medicinalis Anhui
2024;59(12):2198-2203
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To analyze the clinical characteristics of patients with abdominal type allergic purpura(HSP), to improve their diagnostic level, and to explore the risk factors for gastrointestinal bleeding in HSP patients.
Methods :A retrospective analysis was conducted on the clinical manifestations, laboratory data, imaging, endoscopic, and pathological characteristics of 98 patients with abdominal type HSP. Based on the occurrence of gastrointestinal bleeding, 98 patients were divided into a bleeding group and a non-bleeding group, and the risk factors for gastrointestinal bleeding in HSP patients were analyzed.
Results :Abdominal HSP often presented with abdominal pain, vomiting, vomiting blood, black stools, and bloody stools. Imaging often showed edema and thickening of the duodenum and jejunum, as well as enlargement of surrounding lymph nodes. Under endoscopy, the descending part of the duodenum and jejunum mucosa were commonly congested and edematous with erosion, and ulcers were seen in the distal ileum. Pathology commonly involved acute and chronic inflammation of the mucosa with congestion, edema, and local erosion. Patients with gastrointestinal bleeding had significantly higher levels of white blood cell count(WBC), neutrophil count(NEUT), C-reactive protein(CRP), D-dimer(D-D), and fibrinolytic products(FDP) compared to non-bleeding patients(P<0.05), while levels of red blood cell count(RBC), hemoglobin(HGB), and albumin(ALB) were significantly lower than those of non bleeding patients(P<0.05). Logistic regression analysis showed that decreased ALB and increased FDP were independent risk factors for gastrointestinal bleeding in patients with abdominal HSP(P<0.05). The areas under the ROC curves of ALB and FDP were(AUC=0.877, 95%CI:0.794-0.960,P<0.01) and(AUC=0.806, 95%CI:0.722-0.890,P<0.01), respectively. The maximum value of the Jordan index for ALB was 0.734, with sensitivity and specificity of 89.6% and 83.9%, respectively, and had a critical value of 38.2 g/L. The maximum value of the Jordan index for FDP was 0.577, with sensitivity and specificity of 64.2% and 93.5%, respectively, and had a critical value of 18.14 μg/ml. There was no statistically significant difference in the ROC curves between ALB and FDP.
Conclusion :For HSP with abdominal pain as the initial symptom, imaging and endoscopic examination are helpful for early diagnosis. Decreased ALB and elevated FDP are independent risk factors for gastrointestinal bleeding in adult patients with abdominal HSP.
- Full text:2025022716500723980腹型过敏性紫癜的临床特征及消化道出血危险因素分析_张卫平.pdf
