血清CRP、PCT、LDH、cysC水平与蜂螫伤后肾损伤的关系  

Relationship of Serum CRP,PCT,LDH and cys C Levels with Kidney Injury after Bee Sting

作　　者：陈尚扣 黄仁春[1] 石善秋 CHEN Shang-kou;HUANG Ren-chun;SHI Shan-qiu(Department of Emergency Medicine,Hanzhong Central Hospital,Hanzhong Shaanxi 723000)

机构地区：[1]汉中市中心医院急诊医学科,陕西汉中723000

出　　处：《医学临床研究》2022年第8期1157-1160,共4页Journal of Clinical Research

基　　金：陕西省教育厅重点实验室科研计划项目(16JS027)。

摘　　要：【目的】探讨血清C反应蛋白(CRP)、降钙素原(PCT)、乳酸脱氢酶(LDH)、胱抑素C(cysC)水平与蜂螫伤后肾损伤的关系。【方法】回顾性分析130例蜂螫伤患者的临床资料,依据患者是否发生急性肾损伤(AKI)分为AKI组(n=38)与非AKI组(n=92)。在入院时收集两组患者的基线资料信息并行实验室指标[血小板计数(PLT)、CRP、PCT、LDH、cysC]检测。比较两组相关指标的差异,通过受试者工作特征曲线(ROC曲线)分析血清CRP、PCT、LDH、cysC预测蜂螫伤患者并发AKI的价值,并将两组有差异的信息纳入多因素Logistic回归分析,行量化赋值,明确蜂螫伤患者并发AKI的影响因素。【结果】两组性别、年龄、蜂螫伤部位、合并疾病、蜂螫伤时间及PLT水平相比较,差异无统计学意义(P>0.05)。AKI组胡蜂螫伤、伤后入院时间≥6h占比显著高于非AKI组,血清CRP、PCT、LDH、cysC水平显著高于非AKI组,且差异均有统计学意义(P<0.05)。经ROC曲线分析显示,CRP≥6.285mg/L、PCT≥1.570ng/mL、LDH≥1482.175U/L、cysC≥1.430mg/L能够用于预测蜂螫伤患者并发AKI(P<0.05)。经多因素Logistic回归分析证实螫伤蜂种、伤后入院时间及血清CRP、PCT、LDH、cysC水平是蜂螫伤患者并发AKI的显著影响因素(P<0.05)。【结论】血清CRP、PCT、LDH及cysC水平是蜂螫伤患者并发AKI的显著影响因素,且CRP≥6.285mg/L、PCT≥1.570ng/mL、LDH≥1482.175U/L、cysC≥1.430mg/L可预测AKI的发生。【Objective】To investigate the relationship of serum C-reactive protein(CRP),procalcitonin(PCT),lactate dehydrogenase(LDH)and cystatin C(cys C)levels with kidney injury after bee sting.【Methods】The clinical data of 130 patients with bee stings were retrospectively analyzed.According to whether acute kidney injury(AKI),patients were divided into the AKI group(n=38)and the non-AKI group(n=92).At admission,baseline information was collected and laboratory indicators[platelet count(PLT),CRP,PCT,LDH,cys C]were measured.The value of serum CRP,PCT,LDH and cys C in predicting AKI in patients with bee sting was analyzed by ROC.The difference information between the two groups was included in multivariate Logistic regression analysis and quantitative assignment was performed to identify the influencing factors of AKI in patients with bee sting.【Results】There were no significant differences in gender,age,bee sting site,associated diseases,bee sting time and PLT level between the two groups(P>0.05).The proportion of bee stings and hospital admission time≥6 h after injury in the AKI group was significantly higher than that in the non-AKI group,and the levels of serum CRP,PCT,LDH and cys C were significantly higher in the AKI group than those in the non-AKI group,with statistical significance(P<0.05).ROC analysis showed that CRP≥6.285 mg/L,PCT≥1.570 ng/mL,LDH≥1482.175 U/L and cys C≥1.430 mg/L could be used to predict AKI in bee sting patients(P<0.05).Multiple Logistic regression analysis confirmed that wasp species of sting,hospital admission time and serum levels of CRP,PCT,LDH and cys C were significant influencing factors of AKI in patients with bee sting injury(P<0.05).【Conclusion】Serum levels of CRP,PCT,LDH and cys C were significant influencing factors of AKI in bee sting patients.The occurrence of AKI can be predicted when CRP≥6.285 mg/L,PCT≥1.570 ng/mL,LDH≥1482.175 U/L and cys C≥1.430 mg/L showed up.

关 键 词：咬伤和蜇伤 蜂 肾/损伤 C反应蛋白质/血液 降钙素/血液 L-乳酸脱氢酶/血液 抑素类/血液 

分 类 号：R181.2[医药卫生—流行病学]