儿童过敏性紫癜性肾炎病情及发生的预测指标研究进展

Progress in the Study of the Disease and the Predictive Index of the Childhood Henoch-Schonlein Purpura Nephritis

摘要: 儿童过敏性紫癜性肾炎(Henoch-Schonlein Purpura Nephritis, HSPN)是过敏性紫癜(HSP)最严重的并发症之一，对患儿的生活质量和预后有着严重的影响。近年来，HSP出现肾脏损害的危险因素研究已经取得了一定的成绩，但仍存在许多未知可能。本文旨在综述儿童HSPN发生的相关各种危险因素，特别关注炎症指标、感染因素的综合影响。我们分析了炎症指标如白细胞、C-反应蛋白HSPN中的作用，探讨了感染因素，尤其是肺炎支原体感染与肾脏损害之间的关系。同时，我们还总结了血液学指标，如血小板相关指标、D-二聚体、纤维蛋白降解产物及25-羟基维生素D3等在疾病发病机制中的作用及其预测价值。通过系统分析这些因素，本文为临床识别出高危患儿提供重要的理论依据，以期改善HSPN的管理和预后。

Abstract: Henoch-Schönlein purpura nephritis (HSPN), one of the most severe complications of Henoch-Schönlein purpura (HSP), significantly impacts children’s quality of life and prognosis. While recent studies have made progress in identifying risk factors for renal involvement in HSP, many unknown factors remain. This review examines various risk factors associated with pediatric HSPN, with particular focus on the combined effects of inflammatory markers and infectious factors. We analyze the role of inflammatory indicators such as leukocyte counts and C-reactive protein in HSPN, and investigate the relationship between infectious factors—particularly Mycoplasma pneumoniae infection—and renal damage. Additionally, we summarize the roles and predictive value of hematological markers including platelet-related indicators, D-dimer, fibrin degradation products, and 25-hydroxyvitamin D3 in disease pathogenesis. Through systematic analysis of these factors, this study provides crucial theoretical foundations for early clinical identification of high-risk children and the development of personalized treatment strategies, aiming to improve management and prognosis of HSPN.