蝮蛇伤患者血清酶学及C反应蛋白变化的临床研究  

Clinical study of the changes of serum enzyme and C-reactive protein in the patients bitten by agkistrodon halys

作　　者：符秋红[1] 邓立普[1] 曹昕[1] 

机构地区：[1]南华大学附属南华医院急诊科,湖南衡阳421002

出　　处：《中国急救医学》2007年第11期975-978,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的分析蝮蛇伤患者血清酶学及C反应蛋白（CRP）的变化对疾病的病情和预后估计的意义。方法按患者入院时中毒的程度分为轻型、重型、危重型，比较各型之间血清酶及CRP水平；根据SIRS诊断标准将患者分为SIRS组和非SIRS组，比较两组之间血清酶及CRP水平；根据MODS诊断标准将患者分为MODS组和非MODS组，比较两组之间血清酶及CRP水平。结果重型、危重型患者血清酶及CRP水平与轻型比较差异有统计学意义（P〈0．05，P〈0．01，P〈0．001）；SIRS组血清酶及CRP水平与非SIRS组比较差异有统计学意义（P〈0．01，P〈0．05）；MODS组血清酶及CRP水平与非MODS组比较差异有统计学意义（P〈0．05）；SIRS组MODS的发生率明显高于非SIRS组（X^2=19．73，P〈0．001）。结论蝮蛇伤患者病情程度越重，其血清酶学及CRP水平升高越明彤；蝮蛇伤患者并发SIRS时，血清CRP水平升高越明显．MODS发生率越高，病情越严萤：蝮蛇伤患者血清酶学水平与SIRS、MODS的发生关系密切。Objective To study the role of serum marker level including ALT, AST, LDH, CK and CRP in the conditions and prognosis of patients bitten by agkistrodon halys. Methods According to clinical classification and severity degree score standard of venomous snake bite, patients bitten by agkistrodon halys were divided into three types according to intoxication degree on admission： mild, severe and critical type, respectively. Serum marker levels in the patients of three types were compared. Patients were divided into two groups according to SIRS diagnostic criteria： SIRS group and non - SIRS group, respectively. Serum marker levels of the patients in SIRS group and non - SIRS group were compared. Patients were divided into two according to MODS diagnostic criteria： MODS group and non - MODS group, respectively. Serum marker levels of patients in MODS group and non - MODS group were com- pared. Results Compared with mild group, there was significant difference in serum marker levels of severe and critical type（ P 〈0.05 ,P 〈0.01 ,P 〈0. 001 ）. There was significant difference in serum marker levels and CRP between SIRS group and non - SIRS group（P 〈0.01, P 〈0.05） , and between MODS group and non -MODS group（ P 〈0.05）. Incidence of MODS was higher in SIRS group than in non - SIRS group . There was significant difference in incidence of MODS between SIRS and non - SIRS （ X^2 = 19.73, P 〈0.001）. Conclusion The more severe condition of patients bitten by agkistrodon halysis, the higher serum marker levels is. When the patients with SIRS were bitten by agkistrodon halys, serum CRP may markedly rise, incidence of MODS is high, patients＇ conditions become severe. The serum enzyme levels in the patients bitten by agkistrodon halys are clearly associated with occurrence of SIRS and MODS.

关 键 词：蝮蛇伤 全身炎症反应综合征 多器官功能障碍综合征 血清酶 C反应蛋白 ’ 

分 类 号：R646[医药卫生—外科学]