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| Meta analysis of risk factors related to recurrence of henoch schonlein purpura in children |
| HE Songwei1 WANG Junhong2▲ ZHAO Qian1 |
1.Department of Traditional Chinese Medicine, Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing 100045, China;
2.Department of Pediatrics, Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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Abstract Objective To systematically analyze the risk factors related to recurrence of henoch schonlein purpura (HSP) in children. Methods According to the method of evidence-based medicine, the relevant cohort study and case-control study on risk factors for HSP recurrence in children were searched in PubMed, Web of Science, Cochrane Library, CNKI, WanFang database and VIP database from January 2005 to January 2020. Based on inclusion and exclusion criterions, documents that meet the requirements were selected, the quality of the included literatures was evaluated, and the corresponding observation indicators (such as age, gender, race, onset season, course of disease, clinical manifestations, laboratory tests, therapeutic drugs, etc.) were extracted. The meta analysis was performed by RevMan 5.3 software. Results A total of 26 studies with 6933 HSP children were included. Meta analysis results showed that: the recurrent purpura (≥3 times) at first onset of the disease (OR = 2.43, 95%CI: 1.26-4.68, P = 0.008), joint swelling and pain at first onset of the disease (OR = 1.77, 95%CI: 1.07-2.93, P = 0.03), renal damage at first onset of the disease (OR = 2.46, 95%CI: 1.61-3.76, P < 0.0001), allergen positive (OR = 7.74, 95%CI: 3.84-15.60, P ＜ 0.000 01), respiratory tract infection after the first cure (OR = 2.35, 95%CI: 1.58-3.49, P ＜ 0.0001), no preventive medication after the first cure (OR = 5.35, 95%CI: 3.81-7.52, P ＜ 0.000 01), no diet control after the first cure (OR = 2.14, 95%CI: 1.56-2.94, P ＜ 0.000 01), and no sport restriction after the first cure (OR = 3.16, 95%CI: 2.08-4.78, P ＜ 0.000 01) were risk factors for HSP recurrence in children. The subgroup analysis showed that: the risk factors in Chinese population were glucocorticoid therapy (OR = 72.34, 95%CI：13.38-391.05, P < 0.000 01), older age (OR = 2.66, 95%CI:1.94-3.66, P < 0.000 01) and severe abdominal pain at first onset of the disease (OR = 2.19, 95%CI：1.42-3.36, P = 0.0004). The risk factors in non-Chinese population was glucocorticoid therapy (OR = 2.26, 95%CI：1.39-3.68, P = 0.001). Conclusion The risk factors for the recurrence of children’s HSP are the recurrent purpura, joint swelling and pain and renal damage at the first onset of disease, allergen positive, respiratory tract infection, no preventive drugs, no diet control and no sport restriction after the first cure. The recurrence rates of HSP children with older age, use of Glucocorticoid therapy, severe abdominal pain af first onset of the disease were different between Chinese and non-Chinese groups.
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