过敏性紫癜课件_4.pptVIP

* * * * * 治疗 抗血小板药 肝素 尿激酶 治疗 激素和免疫抑制剂 4 缓解腹痛和关节痛 肾病综合症 重症过敏性紫癜性肾炎 治疗 血管紧张素受体阻滞剂(ARB) 、ACEI 的应用 大剂量丙种球蛋白“冲击治疗” 血液净化疗法 中药 其他 5 预后 HSP is generally a benign disease with an excellent prognosis. More than 80% of patients have a single isolated episode lasting a few weeks. Approximately 10-20% of patients have recurrences. Fewer than 5% of patients develop chronic HSP. Abdominal pain resolves spontaneously within 72 hours in most patients 预后 Renal involvement was determined in 58.1%. Nephrotic and/or nephritic syndrome were found to be an unfavorable predictor both for short and long-term outcome (P0.05). However, 35% of these patients and 62% of them showed complete remission after 6 months and long-term course. Overall prognosis of HSN is relatively good and long-term morbidity is predominantly associated with initial presentation and renal involvement. Pediatric Nephrology 21?September?2006 Outcome of Henoch-Sch?nlein purpura nephritis treated with long-term immunosuppression Mohan?Shenoy1, Mark?G.?Bradbury1, Royal Manchester Childrens Hospital This retrospective study investigated the outcome of 27 children (19 male) with Henoch-Sch?nlein purpura nephritis (HSN) of International Study with long-term immunosuppressive therapy single centre over a 10-year period. The treatment protocol comprised daily steroids and cyclophosphamide for 8–12?weeks followed by azathioprine and a reducing regimen of alternate-day steroids for 8–12?months. After a mean follow-up period of 7?years following presentation, 37% made a complete recovery 40.7% had persistent proteinuria, 7.4% had persistent proteinuria and were on antihypertensive therapy 14.8% had progressed to end-stage kidney failure (ESKF). Children with poor outcome were older at presentation (p 0.005), had more crescents (p 0.015) had heavier proteinuria 6?months post initial biopsy (p 0.023). All of the four children with ESKF had nephrotic range proteinuria and greater than 50% crescents