关键词: 紫癜, 过敏性；肾损伤；儿童；病例对照研究；预测；危险因素；脂质代谢；Meta分析

Abstract: Background　Henoch-Schonlein purpura （HSP） is one of the most common vasculitis in children. Some of them may involve the kidney and develop into Henoch Schonlein purpura nephritis，which affects the prognosis. Therefore，it is necessary to find the predictors of renal damage in the early stage of Henoch-Schonlein purpura. In recent years，more and more studies have shown that abnormal lipid metabolism may be a risk factor for HSP renal injury，but there is no systematic evidence-based study. Objective　To comprehensively collect relevant literature and evaluate whether lipid abnormalities in the early stage of HSP can be used as a predictor of HSPN. Methods　PubMed，EMBase，The Cochrane Library，China National Knowledge Infrastructure（CNKI），Wanfang Data Knowledge Service Platform，VIP and China Biology Medicine disc were searched by computer. The retrieval time were from the establishment of the databases to February 10，2020. The first author，publication year，country，diagnostic criteria，gender，age，number of cases（HSPN group / non HSPN group），observation indexes〔total cholesterol （TC），triglyceride（TG），high density lipoprotein （HDL），low density lipoprotein（LDL），apolipoprotein M（ApoM） in the two groups at the initial stage of onset〕，study type，occurrence （initial onset / recurrence），course of disease and follow-up time were collected to study the risk factors of HSPN in children. Newcastle Ottawa scale （NOS） was used to evaluate the quality of the included literature. Stata 15.1 software was used for Meta-analysis. Results　A total of 5 312 cases from 16 literatures were included. Excluding 26 cases lost to follow-up，there were 5 286 children with HSP，and 1 997 cases developed HSPN，with NOS scores ≥6 points. The results of meta-analysis showed that the levels of TC 〔WMD=0.72，95%CI （0.51，0.92）〕，TG 〔WMD=0.61，95%CI （0.45，0.77）〕 and LDL〔WMD=0.65，95%CI （0.41，0.89）〕 in HSPN group were higher than those in non HSPN group，and the level of ApoM 〔OR=0.32，95%CI （0.12，0.85）〕 was lower than those in non HSPN group. Conclusion　High levels of TC，TG and LDL may be predictors of HSPN development. The relationship between HDL level and HSPN is still unclear，which needs to be confirmed by further research. ApoM is expected to become a new independent predictor of HSPN.

Key words: Purpura, Schoenlein-Henoch；Renal involvement；Child；Case-control studies；Forecasting；Risk factors；Lipid metabolism；Meta analysis