摘要
胡蜂蛰伤是我国导致急性肾损伤(acute kidney injury,AKI)的重要原因之一,但目前相关的临床研究较少。胡蜂毒素成分复杂,主要包括酶类、生物胺类、肽类及其他成分。胡蜂蜇伤可导致过敏反应及全身毒性反应如AKI等。胡蜂蛰伤致AKI主要为继发于血管内溶血和/或横纹肌溶解,也可通过蜂毒的直接肾毒性导致。胡蜂蛰伤致AKI患者行肾穿刺活检表明大部分患者肾脏病理改变表现为急性肾小管坏死,部分患者表现为急性间质性肾炎。不同的肾脏替代治疗方式被用于治疗胡蜂蛰伤致AKI,推荐在血流动力学不稳定时优先选择持续肾脏替代治疗。结合研究组新近研究进展,就近年来蜂蛰伤致AKI治疗(特别是肾脏替代治疗)及预后评估方面的新进展做一总结。
Wasp sting is one of the important causes of acute kidney injury (AKI) in China,but there are few related clinical studies. The constituents of wasp venom are complex,mainly including enzymes,biogenic amines,peptides and other components. Wasp sings can induce allergic reactions and systemic toxic reactions such as AKI. AKI induced by wasp stings is usually mediated by a combination of intravascular hemolysis and/or rhabdomyolysis,and can also be caused by direct nephrotoxic effects of the bee venom.Renal biopsy of patients with AKI caused by wasp stings has demonstrated that most patients have pathological changes of acute tubular necrosis,and some develop acute interstitial nephritis. Different renal replacement therapies have been used to treat severe AKI induced by wasp stings. Continuous renal replacement therapy is recommended in patients with hemodialysis instability. In this review,we aim to integrate results reported in recent years by ourselves and others to summarize the new progress in the treatment and prognosis of AKI.
作者
巩建华
袁海
高召
胡凤琪
GONG Jianhua;YUAN Hai;GAO Zhao;HU Fengqi(Department of Nephrology,Xiangyang Central Hospital,Hubei University of Arts and Science,Xiangyang,Hubei 441000,China)
出处
《公共卫生与预防医学》
2019年第3期107-111,共5页
Journal of Public Health and Preventive Medicine
基金
国家自然科学基金(81300617)
湖北省卫计委青年人才项目(WJ2015Q038)
关键词
蜂蛰伤
急性肾损伤
肾脏替代治疗
Wasp stings
Acute kidney injury
Renal replacement therapy
