早期炎症标志物对胡蜂蜇伤致急性呼吸窘迫综合征预后的预测  

Early indicators of inflammation as a predictor of prognosis in acute respiratory distress syndrome due to wasp stings

作　　者：赵知文 雷金琳 刘雪芳 许弘毅 吴泽宇 方志成[1] ZHAO Zhiwen;LEI Jinlin;LIU Xuefang;XU Hongyi;WU Zeyu;FANG Zhicheng(Department of Emergency Medicine,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei,442000,China;School of Public Health,Hubei University of Medicine)

机构地区：[1]湖北医药学院附属太和医院急诊医学科,湖北十堰442000 [2]湖北医药学院公共卫生与健康学院

出　　处：《临床急诊杂志》2024年第5期255-259,共5页Journal of Clinical Emergency

基　　金：湖北医药学院研究生科技创新项目(No:YC2023037);湖北省卫生健康委员会面上项目(No:WJ2023M164)。

摘　　要：目的:探究早期炎症标志物对胡蜂蜇伤致急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)预后的预测。方法:通过选取2017年1月—2023年12月湖北医药学院附属太和医院急诊医学科及分院收治的50例胡蜂蜇伤致ARDS的患者,根据28 d预后,分为存活组(23例)和死亡组(27例)。比较两组患者早期炎症标志物[白细胞计数(WBC)、中性粒细胞绝对值(NEUT^(#))、淋巴细胞绝对值(LYMPH^(#))、单核细胞计数(EO^(#))、降钙素原(PCT)、C-反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)],分析早期炎症标志物在两组之间的差异。结果:早期炎症标志物在胡蜂蜇伤致ARDS两组患者中差异有统计学意义,存活组的WBC 16.76×10~9/L(13.43×10~9/L,23.00×10~9/L)、NEUT^(#)16.45×10~9/L(12.96×10~9/L,21.84×10~9/L)、CRP 9.86(3.04,19.22)mg/L、PCT 8.05(7.12,10.29)μg/L、NLR 22.53(19.06,26.24)显著低于死亡组患者,差异有统计学意义(P<0.05)。单因素logistic分析显示WBC、NEUT^(#)、CRP、PCT及NLR差异均有统计学意义。同时,通过ROC曲线进一步验证早期炎症标志物的特异度和灵敏度。结论:本研究结果表明早期炎症标志物升高是患者预后不良的重要因素,可为胡蜂蜇伤致ARDS的临床诊治提供一定指导。Objective:To investigate the prediction of early inflammatory markers on the prognosis of acute respiratory distress syndrome due to wasp sting.Methods:By selecting 50 patients admitted to the Department of Emergency Medicine and Branch Hospital of Taihe Hospital Affiliated to Hubei Medical College from January 2017 to December 2023 with hornet sting causing acute respiratory distress syndrome,they were divided into the survival group(23 cases) and the death group(27 cases) according to the 28-day prognosis.Early inflammatory markers[white blood cell count(WBC),absolute neutrophil count(NEUT~#),absolute lymphocyte count(LYMPH~#),monocyte count(EO#),procalcitoninogen(PCT),C-reactive protein(CRP),and neutrophil-to-lymphocyte ratio(NLR) ]were compared in the 2 groups of study subjects,and the differences in early inflammatory markers were analysed between these 2 groups.Results:Early inflammatory markers were significantly different in the two groups of patients with acute respiratory distress syndrome due to wasp sting,with WBC 16.76×10~9/L(13.43×10~9/L,23.00×10~9/L),NEUT~#16.45×10~9/L(12.96×10~9/L,21.84×10~9/L),CRP 9.86(3.04,19.22)mg/L,PCT 8.05(7.12,10.29)μg/L,and NLR 22.53(19.06,26.24) were significantly lower than those of patients in the death group and(P<0.05).One-way logistic analysis showed that WBC,NEUT~#,CRP,PCT and NLR were statistically significant.Meanwhile,the specificity and sensitivity of early inflammatory markers were further verified by ROC curve.Conclusion:The results of this study indicate that elevated early inflammatory markers are important factors in the poor prognosis of patients,which may provide some insights into the clinical diagnosis and treatment of ARDS caused by wasp stings.

关 键 词：胡蜂蜇伤 急性呼吸窘迫综合征 早期炎症标志物 预后 

分 类 号：R646[医药卫生—外科学]