蜂蜇伤所致急性肾损伤患者的红细胞分布宽度表达特点及临床意义  

Expression characteristics and clinical significance of red cell distribution width in patients with acute kidney injury caused by bee sting

作　　者：尹松林[1] 蒲蓉 牟天易 麦超[1] YIN Songlin;PU Rong;MOU Tianyi;MAI Chao(Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000;Department of Pediatrics,Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院附属医院急诊科,四川南充637000 [2]川北医学院附属医院儿科,四川南充637000

出　　处：《临床与病理杂志》2022年第3期609-614,共6页Journal of Clinical and Pathological Research

摘　　要：目的:探讨蜂蜇伤所致急性肾损伤(acute kidney injury,AKI)患者的红细胞分布宽度(red blood cell distribution width, RDW)表达特点和临床意义。方法:回顾性分析2017年2月至2021年5月川北医学院附属医院急诊科收治且经过筛选的92例蜂蜇伤患者的病历资料,依据有无AKI发生分成AKI组(18例)与无AKI组(74例),AKI组进一步分成I期组(n=10)和II~III期组(n=8)。整理入院24 h内的相关检查资料,对不同组间RDW和肾损伤指标[血清肌酐(serum creatinine,SCr)、胱抑素-C(cystatin-C,Cys-C)]进行比较分析。结果:与无AKI组比较,AKI组RDW、白细胞计数、SCr和Cys-C均显著升高,差异均有统计学意义(均P <0.0 5);与I期组比较,I I~I I I期组RDW、 SCr和Cys-C也显著较高,差异均有统计学意义(均P<0.05)。蜂蜇伤患者RDW、SCr和Cys-C均呈正相关(r=0.560、r=0.712,均P<0.05)。受试者工作特征(receiver operating characteristic,ROC)曲线显示,蜂蜇伤患者入院RDW预测AKI发生的曲线下面积(area under curve,AUC)为0.758(95%CI:0.627~0.888),截断值为14.80%,敏感度和特异度分别为72.22%、82.43%。结论:蜂蜇伤所致AKI患者RDW多呈异常升高表达,RDW可作为预测AKI发生和评估AKI病情程度的有效指标。Objective: To investigate the expression characteristics and clinical significance of red cell distribution width(RDW) in patients with acute kidney injury(AKI) caused by bee sting. Methods: The medical records of 92 patients with bee sting treated in the Emergency Department of the Affiliated Hospital of North Sichuan Medical College from February 2017 to May 2021 were analyzed retrospectively. According to the occurrence of AKI, the patients were divided into an AKI group(n=18) and a non-AKI group(n=74). The AKI group was further divided into the stage I group(n=10) and the stage II–III group(n=8). The related examination data within 24 hours after the admission were sorted out, and the RDW and renal injury indexes [serum creatinine(SCr), cystatin-C(Cys-C)] between different groups were compared and analyzed. Results: Compared with the non-AKI group, RDW, WBC count, SCr and Cys-C were significantly increased in the AKI group(P<0.05). Compared with the stage I group, RDW, SCr and Cys-C were also significantly higher in the stage II–III group(P<0.05). RDW, SCr and Cys-C were positively correlated in bee sting patients(r=0.560, r=0.712, P<0.05). Receiver operating characteristic(ROC) curve showed that the area under curve(AUC) of RDW was 0.758(95%CI: 0.627 to 0.888), the cutoff value was 14.80%, the sensitivity and specificity were 72.22% and 82.43%, respectively. Conclusion: The expression of RDW in patients with AKI caused by bee sting is abnormally increased, and RDW can be used as an effective index to predict the occurrence of AKI and evaluate the severity of AKI.

关 键 词：蜂蜇伤 急性肾损伤 血清肌酐 胱抑素-C 预测 评估 

分 类 号：R692[医药卫生—泌尿科学] R646[医药卫生—外科学]