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

摘要： 背景　过敏性紫癜（HSP）是儿童最常见的血管炎之一，部分可累及肾脏发展为紫癜性肾炎（HSPN），影响预后。因此在HSP的发病早期寻找肾脏损伤的预测因子十分必要，近年来越来越多的研究表明脂质代谢异常可能是HSP肾脏损伤的危险因素，然而未见系统的循证研究。目的　全面搜集相关文献，评估HSP发病早期脂质代谢异常是否能作为HSPN的预测因子。方法　计算机检索PubMed、EMBase、The Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库，检索时间为建库至2020-02-10。收集第一作者、发表年份、国家、诊断标准、性别、年龄、例数（HSPN组/非HSPN组）、观察指标〔两组人群起病时的总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白M（ApoM）〕、研究类型、发生情况（初发/复发）、病程、随访时间，运用纽卡斯尔-沃太华量表（NOS）对纳入文献进行质量评估，Stata 15.1软件进行Meta分析。结果　共纳入16篇文献5 312例患者，失访26例，纳入HSP患儿5 286例，其中1 997例发展为HSPN，NOS评分均≥6分。Meta分析结果显示：HSPN组患者起病时的TC水平〔WMD=0.72，95%CI（0.51，0.92）〕、TG水平〔WMD=0.61，95%CI（0.45，0.77）〕、LDL水平〔WMD=0.65，95%CI（0.41，0.89）〕高于非HSPN组，ApoM水平〔OR=0.32，95%CI（0.12，0.85）〕低于非HSPN组。结论　高水平的TC、TG和LDL可能是HSP发展为HSPN的预测因子，HDL水平与HSPN关系尚不明确，有待进一步研究证实，ApoM有望成为HSPN的新独立预测因子。

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