摘要
目的探讨成人腹型过敏性紫癜的临床特点与内镜表现,为该病早期诊断提供依据。方法对32例成人腹型过敏性紫癜的临床特点与内镜表现进行回顾分析。结果32例患者均有腹部绞痛,腹痛部位多变而不固定,症状严重而腹部体征轻微,59.4%的患者伴恶心、呕吐,50%的患者有呕血、便血,大便潜血全部阳性,25%患者血尿淀粉酶升高,腹痛发生后2-10d出现下肢紫癜。内镜检查可见胃肠黏膜充血、水肿、出血点、糜烂、溃疡,以十二指肠、回肠末段、回盲部和升结肠黏膜病理改变最严重,食管黏膜正常。临床和内镜的误诊率分别为87.5%和85.7%。解痉剂和抗酸药物治疗无效,糖皮质激素有效。结论腹型过敏性紫癜患者的胃肠黏膜广泛散在大小不一的出血点和雪花状多发性溃疡。临床表现无特异性,腹痛剧烈而部位多变、腹部体征轻微,是其临床特点之一。
[Abstract] Objective To evaluate the clinical and endoscopic manifestations of abdominal type allergic purpura in adult patients as the evidences in reaching early diagnosis. Methods The clinical and endoscopic manifestations of 32 patients with abdominal type allergic purpura were analyzed retrospectively. Re-SllltS All the patients complained of paroxysmal abdominal colic, 59. 4% patients complained of nausea and vomiting, 50% patients had hematochezia and haematemesis, the occult blood test was positive in all patients, and 25% patients had elevated level of amylase in the blood and urine. Purpura was found in 2-10 days after the presentation of abdominal pain. Endoscopy found hyperaemia, edema, bleeding spots, erosion and ulcer in gastroenterologic mucosa. Duodenal, ileum and caecum had more severe mucous lesions, but the esophageal mucosas in all patients were normal. The clinic and endoscopic misdiagnosis rates were 87.5% and 85.7% respectively. Glucocorticoids were the especially effective medicine in its treatment, while those agents for relieving spasm or antacids were ineffective. Conclusion Many scattered bleeding spots and snow flower-like ulcers on the gastrointestinal mucosa are the most important findings in adult abdominal type allergic purpura patients. Clinic manifestations of these patients are very severe abdominal colic in indefinite sites and merely with mild abdominal objective signs is the important characteristic feature.
出处
《中华消化内镜杂志》
2005年第2期108-110,共3页
Chinese Journal of Digestive Endoscopy
