胡蜂蛰伤患者伤后1周血清肌酸激酶的变化规律及其对肌酐的影响  

Changes of creatine kinase and its effect on renal function in patients with wasp sting one week after injury

作　　者：王兰 郭新成[1] 刘海霞 张冬菊[1] 赵晓静[2] WANG Lan;GUO Xincheng;LIU Haixia;ZHANG Dongju;ZHAO Xiaojing(Department of Critical Care Medicine,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China;Department of General Practice,Xi′an Jiaotong University,Xi′an,Shaanxi 710000,China)

机构地区：[1]汉中市中心医院重症医学科,陕西汉中723000 [2]西安交通大学第二附属医院全科医学科,陕西西安710000

出　　处：《检验医学与临床》2023年第S01期14-16,共3页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划资助项目(2020SF-181)。

摘　　要：目的总结胡蜂蛰伤患者伤后1周内血清肌酸激酶(CK)的变化规律及其对肌酐的影响。方法选取汉中市中心医院2014年7月至2021年8月之间收住院的240例胡蜂蜇伤患者为研究对象,对其临床资料进行回顾性分析,总结其伤后1周的CK的变化规律及其对肌酐的影响。结果CK峰值水平>1000 U/L的患者共有149例,峰值均出现在前4天内,其中伤后第2天占比44.30%,第3天占比33.56%。240例患者中Cr>110μmol/L共50例(20.83%),CK峰值水平越高,Cr>110μmol/L的比例越高。受试者工作特征曲线下面积为0.882(95%CI:0.832~0.932,P<0.001)。CK峰值≥6800.5 U/L时,对应的灵敏度为77.6%,特异度为83.8%。结论胡蜂蛰伤患者CK达峰值时间在伤后第1~4天,其中以第2~3天最常见。CK峰值水平对Cr>110μmol/L有较好的预测价值,CK峰值的界值为6800.5 U/L时,对应Cr升高的灵敏度为77.6%,特异度为83.8%。Objective To summarize the changes of serum creatine kinase(CK)and its effect on renal function in patients with wasp sting within 1 week after injury.Methods A total of 361 patients with wasp sting hospitalized in Hanzhong Central Hospital from July 2014 to August 2021 were selected as the research object.Their clinical data were retrospectively analyzed to summarize the changes of CK and its effect on renal function one week after injury.Results There were 149 patients with CK peak level>1000μmol/L,and the peak value occurred in the first 4 days,including 44.30%on the second day and 33.56%on the third day.240 patients,50 patients(20.83%)had serum creatinine(Cr)>110μmol/L.The higher the peak level of CK,the higher the proportion of Cr>110μmol/L.ROC curve was performed,and the area under the curve was 0.882(95%CI:0.832-0.932,P<0.001).When the peak value of CK≥6800.5 U/L,the corresponding sensitivity was 77.6%and the specificity was 83.8%.Conclusion The peak time of serum creatine kinase in patients with wasp sting was 1-4 days after injury,and the most common was 2-3 days.The peak level of CK has a good predictive value for Cr>110μmol/L.When the boundary value of CK peak is 6800.5 U/L,the sensitivity and specificity corresponding to the increase of Cr are 77.6%and 83.8%.

关 键 词：胡蜂蜇伤 横纹肌溶解 血清肌酸激酶 肾损伤 

分 类 号：R646[医药卫生—外科学] R459.7[医药卫生—临床医学]