To explore the clinical values and therapeutic indications of blood perfusion as secondary treatment of children with Henoch-Schonlein purpura (HSP).

From April 2013 to April 2015, a total of 239 HSP children hospitalized in Chengdu Women′s & Children′s Central Hospital were selected as research subjects. According to their diseases severity and different treatment strategies, they were divided into four groups, including observation group with mild HSP (n=76, children with mild HSP and treated with routine therapy and blood perfusion), control group with mild HSP (n=84, children with mild HSP and treated with routine therapy), and observation group with severe HSP (n=47, children with severe HSP and treated with routine therapy and blood perfusion) and control group with severe HSP (n=32, children with severe HSP and treated with routine therapy) . Routine therapy included antiinflammatory, antianaphylaxis, anticoagulation and symptomatic treatment, and blood perfusion was as adjunctive therapy. Case data of 239 children with HSP were retrospectively analyzed. The evaluating indicators of short-term efficacy of improved clinical symptoms after treatment in acute stage, and 2 long-term efficacies of rash recurrence rates and the incidences of kidney damage in one year between 2 groups of mild or severe HSP children were compared statistically by t test or chi-square test. This study was consistent with the World Medical Association Declaration of Helsinki revised in 2013 and informed consents were signed by the guardians of children.

①The symptoms disappearance time of abdominal pain and bloody stools, and joint pain, and purpura alleviated time in observation group with severe HSP [(4.8±0.6) d, (3.0±0.7) d, (3.4±0.8) d] were all shorter than those in control group with severe HSP [(5.8±0.5) d, (4.2±0.8) d, (4.5±0.7) d], and all the differences were statistically significant (t=15.499, 7.060, 6.040; P<0.001). There were no significant differences between two groups of children with severe HSP in recurrence rates of rashes and incidence rates of renal damage in one year of follow-up (P>0.05). There were no significant differences between two groups of children with mild HSP in above 5 indicators (P>0.05). ②At the 7th day after treatment, the levels of microalbumin, transferrin, α1 and β2 microglobulin in urine, and the serum interleukin (IL)-1 and tumor necrosis factor (TNF)-α in observation group with severe HSP [(20.6±15.0) mg/L, (6.6±0.6) mg/L, (8.0±1.0) mg/L, (0.32±0.23) mg/L, (6.9±1.6) mg/L, (9.6±2.9) mg/L] were all lower than those in control group with severe HSP [(38.4±10.4) mg/L, (9.0±1.0) mg/L, (10.2±1.7) mg/L, (3.50±1.40) mg/L, (8.3±1.7) mg/L, (12.9±2.8) mg/L], and the differences were statistically significant (t=5.804, 13.191, 6.686, 15.286, 3.823, 5.004; P<0.001). There were no significant differences between two groups of children with mild HSP in above 6 indicators (P>0.05).

Blood perfusion can relieve clinical symptoms and alleviate acute kidney injury of children with severe HSP, but it has not yet been found that blood perfusion has a preventive effect on rash recurrence and occurrence of renal injury neither in children with mild HSP nor in children with severe HSP. It is recommended that blood perfusion should only be used for adjuvant treatment for children with severe HSP.