目的 明確抗鏈球菌溶血素O陽(yáng)性是否為小兒過敏性紫癜復(fù)發(fā)率的危險(xiǎn)因素，以期為預(yù)防其復(fù)發(fā)提供臨床指導(dǎo)依據(jù)。方法 選擇2014年1月-2015年12月綿陽(yáng)市中醫(yī)醫(yī)院收治的過敏性紫癜患兒136例，回顧性分析其臨床資料，根據(jù)患兒出院后12個(gè)月內(nèi)是否復(fù)發(fā)，將患兒分為復(fù)發(fā)組（n=48）和未復(fù)發(fā)組（n=88），統(tǒng)計(jì)兩組患兒入院時(shí)抗鏈球菌溶血素O的陽(yáng)性率，采用多因素logistics回歸分析探討過敏性紫癜患兒復(fù)發(fā)的危險(xiǎn)因素。結(jié)果 復(fù)發(fā)組患兒抗鏈球菌溶血素O的陽(yáng)性率顯著高于未復(fù)發(fā)組，差異有統(tǒng)計(jì)學(xué)意義（66.67% vs 32.95%，P=0.000）。多因素logistics回歸分析顯示消化道出血、關(guān)節(jié)炎和抗鏈球菌溶血素O陽(yáng)性均為過敏性紫癜患兒復(fù)發(fā)的危險(xiǎn)因素（P<0.05）。對(duì)于抗鏈球菌溶血素O陽(yáng)性的患兒，未接受抗鏈球菌治療者的復(fù)發(fā)率顯著高于接受抗鏈球菌治療的患兒（44.00% vs 23.26%，P=0.036）。結(jié)論 抗鏈球菌溶血素O陽(yáng)性為過敏性紫癜患兒復(fù)發(fā)的危險(xiǎn)因素，通過加強(qiáng)對(duì)抗鏈球菌溶血素O陽(yáng)性患兒的抗鏈球菌治療可降低其復(fù)發(fā)率。

Objective To analyze whether positive antistreptolysin O is the risk factor for the recurrence of allergic purpura in children. Methods A total of 136 children with allergic purpura in our hospital from January 2014 to December 2015 were selected, and the clinical data were analyzed retrospectively. According to the recurrence within 12 months after discharge from the hospital, the children were assigned into the recurrence group (n=44) or the non-recurrence group (n=88). The positive rate of antistreptolysin O between the recurrence group and the non-recurrence group were compared and the risk factors of recurrence in children with allergic purpura were analyzed. Results The positive rate of antistreptolysin O of the recurrence group was significantly higher than that of the non-recurrence group, and the difference was statistically significant. (66.67% vs 32.95%, P=0.000). Logistics regression analysis showed that the digestive tract hemorrhage, arthritis and positive antistreptolysin O were risk factors for recurrence in children with allergic purpura (P<0.05). For children with positive antistreptolysin O, those who did not receive the antistreptococcal treatment got a higher recurrence rate than those received antistreptococcal treatment (44% vs 23.26%, P=0.036). Conclusion Positive antistreptolysin O is a risk factors for recurrence in children with allergic purpura. By strengthening antistreptococcal treatment against streptococcus hemolysin O positive children, the recurrence rate is expected to be reduced.