摘要
目的探讨蜂蛰伤后并发多脏器功能障碍综合征(MODS)的危险因素。方法回顾性分析皖南医学院附属黄山市人民医院急诊科2015年8月至2020年12月收治的95例蜂蜇伤患者的临床资料。13例蜂蛰伤后并发MODS为MODS组,82例蜂蛰伤后未出现MODS者为非MODS组。比较两组的白细胞(WBC)、血红蛋白(HGB)、血小板(PLT)、尿素氮(BUN)、血清肌酐(Scr)、丙氨酸氨基转移酶(ALT)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)及入院3 h超敏肌钙蛋白(hs-cTnI)、活化部分凝血酶原时间(APTT)、C反应蛋白(CRP)。将组间有差异的变量纳入多因素Logistic回归模型进行分析,筛选出蜂蛰伤并发MODS的危险因素。结果两组患者HGB、WBC、PLT、APTT和CRP比较,差异无统计学差异(P>0.05)。MODS组患者的BUN、Scr、ALT、LDH、CK-MB和入院3 h的hs-cTnI较非MODS组明显增高,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,入院3 h的hs-cTnI为预测MODS的独立危险因素。MODS组CK-MB异常、hs-cTnI异常及肝、肾功能损伤患者比例、病死率均显著高于非MODS组,住院时间长于非MODS组,差异均有统计学意义(P<0.05)。两组APTT异常患者比例比较,差异无统计学意义(P>0.05)。结论入院3 h的hs-cTnI是蜂蛰伤患者并发MODS的独立危险因素,可作为蜂蛰伤并发MODS的早期预测指标。
Objective To investigate the risk factors of bee stings complicated with multiple organ dysfunction syndrome(MODS).Methods A retrospective study was performed on 95 cases of patients with bee stings who were admitted from August 2015 to December 2020.There were 13 patients with MODS after bee stings in the MODS group,82 patients with no MODS after bee stings were in the non-MODS group.The white blood cells(WBC),hemoglobin(HGB),platelet(PLT),urea nitrogen(BUN),serum creatinine(Scr),alanine aminotransferase(ALT),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB)and high-sensitive troponin I(hs-cTnI)at 3 hours after admission,activated partial thromboplastin time(APTT)and C-reactive protein(CRP)were compared between two groups.Variables with differences between the groups were included in the multivariate Logistic regression model for analysis,and the risk factors of bee stings complicated with MODS were screened out.Results There were no significant differences in HGB,WBC,PLT,APTT and CRP between MODS group and non-MODS group(P>0.05).The levels of BUN,Scr,ALT,LDH,CK-MB and hs-cTnI 3 hours after admission in the MODS group were significantly higher than those in the non-MODS group(P<0.05).Logistic regression analysis showed that hs-cTnI at 3 hours after admission was an independent risk factor for predicting MODS.In the MODS group,liver and renal function injury,abnormal proportion of CK-MB and hs-cTnI and mortality were significantly higher than those in the non-MODS group,and the length of hospital stay was longer than that in the non-MODS group(P<0.05).There was no significant difference in the proportion of patients with abnormal APTT between the two groups(P>0.05).Conclusion Hs-cTnI at 3 hours after admission is an independent risk factor for MODS in patients with bee stings,which can be used as an early predictor of MODS in patients with bee stings.
作者
凤尔稳
凌进华
朱冠能
张斌传
王秀英
FENG Er-wen;LING Jin-hua;ZHU Guan-neng;ZHANG Bin-chuan;WANG Xiu-ying(Department of Emergency Medicine,Huangshan People′s Hospital,Wannan Medical College,Huangshan 245000,China)
出处
《创伤与急危重病医学》
2021年第2期93-96,共4页
Trauma and Critical Care Medicine
基金
安徽省医学会急诊医学临床研究项目(Ky2021004)。
关键词
超敏肌钙蛋白
蜂蛰伤
多脏器功能障碍综合征
High-sensitive troponin I
Bee stings
Multiple organ dysfunction syndrome
