蜂蛰伤致肝损伤患者临床特征及危险因素分析  

Analysis of clinical features and risk factors of liver injury patients caused by bee sting

作　　者：何奂 王建春 HE Huan;WANG Jianchun(Diagnostic Laboratory,Shenzhen Samii Medical Center,Shenzhen City,Guangdong Province,518118,China)

机构地区：[1]广东省深圳市萨米医疗中心医学检验科,广东深圳518118

出　　处：《蛇志》2024年第1期42-46,共5页Journal of Snake

摘　　要：目的探讨蜂蛰伤致肝损伤患者的临床特征及肝损伤发生的危险因素。方法采用回顾性研究的方法,选择广西壮族自治区百色市德保县人民医院外科2017年1月至2021年12月收治的蜂蛰伤患者182例,将丙氨酸氨基转移酶(ALT)≥80 U/L和(或)总胆红素(TBIL)≥34.2μmol/L的患者分为肝损伤组(n=26),其余患者分为非肝损伤组(n=156)。比较两组患者的实验室结果[红细胞(RBC)、白细胞(WBC)、中性粒细胞(NEUT)、中性粒细胞占比(NEUT%)、淋巴细胞(LYM)、淋巴细胞占比(LYM%)、中性粒细胞/淋巴细胞比值(NRL)、血红蛋白(HB)、血小板计数(PLT)、血小板体积(MPV)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胱抑素C(CYSC)、尿素(UREA)、肌酐(CREA)、尿酸(UA)]等差异性,并采用Logistic回归分析肝损伤的危险因素。结果(1)女性肝损伤的发生率为13.16%(10/76),男性肝损伤率为15.09%(16/106),两者比较差异无统计学意义(P>0.05)。(2)两组患者的ALT、TB、AST、UA、PT、APTT指标水平比较,差异均有统计学意义(均P<0.05)。(3)Logistic回归分析结果显示,AST(OR=1.011,95%CI:1.006~1.017,P=0.000)、PT(OR=1.688,95%CI:1.261~2.260,P=0.000)是蜂蛰伤发生肝损伤的独立危险因素。结论蜂蛰伤后需要及时监测患者的AST、PT指标水平,尽早干预以预防肝损伤的发生。Objective To investigate the clinical features and risk factors of liver injury caused by bee sting.Methods A retrospective study was conducted,and 182 patients with bee stings who visited to the surgery department of Debao County People's Hospital from January 2017 to December 2021 were selected as the study subjects.The patients with alanine aminotransferase(ALT)≥80 U/L and/or total bilirubin(TBIL)≥34.2μmol/L were divided into liver injury group(26 patients),and the other patients were divided into non-liver injury group(156 patients).The laboratory results of the two groups were compared,including RBC,WBC,NEUT,NEUT(%),LYM,LYM(%),NRL,HB,PLT,MPV,prothrombin time(PT),activated partial thromboplastin time(APTT),TT,FIB,TBIL,ALT,aspartate aminotransferase(AST),CYSC,UREA,CREA,uric acid(UA)and the risk factors of liver injury were analyzed.Results(1)The incidence of liver injury in female patients was 13.16%(10/76),and that in male patients was 15.09%(16/106),and the difference was not statistically significant(P>0.05).(2)There were significant differences in ALT,TBIL,AST,UA,PT and APTT between the liver injury group and the non-liver injury group(P<0.05).(3)Logistic regression model analysis showed that AST(OR=1.011,95%CI:1.006~1.017,P=0.000)and PT(OR=1.688,95%CI:1.261~2.260,P=0.000)were independent risk factors for liver injury after bee sting.Conclusion After bee sting,it is necessary to monitor the AST and PT indexes of patients in time and intervene as early as possible to prevent liver injury.

关 键 词：蜂蛰伤 肝损伤 危险因素 

分 类 号：R646[医药卫生—外科学] R595.8[医药卫生—临床医学]