摘要
【目的】探讨小儿蜂蜇伤中毒后致急性肾损伤(AKI)的相关影响因素。【方法】回顾性分析在本院接受治疗的120例蜂蜇伤中毒患儿的临床资料,根据患儿是否存在AKI分为AKI组(n=46)和非AKI组(n=74)。收集并比较两组患儿一般资料、蜇伤至入院时间等各项信息及入院时红细胞(RBC)计数、白细胞(WBC)计数、血红蛋白(Hb)、血钾离子(K^(+))、血钙离子(Ca^(2+))、二氧化碳结合力(CO_(2)CP)、尿素氮(BUN)、血肌酐(Scr)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、丙氨酸氨基转氨酶(ALT)、天冬氨酸转氨酶(AST)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)等各项指标。使用受试者工作特征(ROC)曲线分析相关指标对小儿蜂蜇伤中毒后AKI发生的预测价值,将有差异的单因素纳入Logistic模型,行量化赋值,分析小儿蜂蜇伤中毒后AKI发生的危险因素。【结果】AKI组蜇伤至入院时间、WBC计数、K^(+)、Scr、CK-MB、CK、LDH、ALT、AST水平均显著高于非AKI组,且差异有统计学意义(P<0.05)。经ROC分析,蜇伤至入院时间、WBC计数、K^(+)、Scr、CK-MB、CK、LDH、ALT、AST预测小儿蜂蜇伤中毒后AKI的曲线下面积分别为0.943、0.876、0.845、0.947、0.875、0.920、0.906、0.919、0.956(均P<0.05)。经多因素Logistic回归分析证实,蜇伤至入院时间≥11.245 h、WBC计数≥14.095×10^(9)/L、K^(+)≥5.5 mmol/L、Scr≥129.490μmol/L、CK-MB≥50.130 U/L、CK≥371.410 U/L、LDH≥470.135 U/L、ALT≥83.745 U/L、AST≥96.195 U/L是小儿蜂蜇伤中毒后发生AKI的危险因素。【结论】小儿蜂蜇伤中毒后发生AKI与蜇伤至入院时间、WBC计数、K+、Scr、CK-MB、CK、LDH、ALT、AST密切相关,临床应予以关注。
【Objective】To explore the influencing factors of acute kidney injury(AKI)in children after bee sting poisoning.【Methods】A retrospective analysis of clinical data from 120 children with bee sting poisoning was conducted.According to the presence or absence of AKI,they were divided into the AKI group(n=46)and non-AKI group(n=74).General information,such as the time from sting to admission and the blood tests at admission including red blood cells(RBC),white blood cells(WBC),hemoglobin(Hb),potassium ions(K^(+)),calcium ions(Ca^(2+)),carbon dioxide combining power(CO_(2)CP),blood urea nitrogen(BUN),serum creatinine(Scr),creatine kinase isoenzyme(CK-MB),creatine kinase(CK),lactate dehydrogenase(LDH),alanine aminotransferase(ALT),aspartate aminotransferase(AST),prothrombin time(PT),activated partial thromboplastin time(APTT),were collected and compared between the two groups.Receiver operating characteristic(ROC)curves were used to analyze the predictive value of these indicators for AKI after bee sting poisoning in children.The single factors with differences were incorporated into the logistic model to quantify and identify the risk factors for AKI after bee sting poisoning in children.【Results】The time from sting to admission and levels of WBC,K^(+),Scr,CK-MB,CK,LDH,ALT,and AST in the AKI group were significantly higher than those in the non-AKI group with statistical significance(P<0.05).ROC analysis showed that the areas under the curve of time from sting to admission,WBC、K^(+),Scr,CK-MB,CK,LDH,ALT,and AST for predicting AKI after bee sting poisoning in children were 0.943,0.876,0.845,0.947,0.875,0.920,0.906,0.919,and 0.956,respectively(all P<0.05).Multivariate logistic regression analysis confirmed that time from sting to admission≥11.245 h,WBC≥14.095×10^(9)/L,K^(+)≥5.5 mmol/L,Scr≥129.490μmol/L,CK-MB≥50.130 U/L,CK≥371.410 U/L,LDH≥470.135 U/L,ALT≥83.745 U/L,AST≥96.195 U/L were risk factors for AKI after bee sting poisoning in children.【Conclusion】The occurrence of AKI in children after bee sting poisoning is closely related to the time from sting to admission,WBC,K^(+),Scr,CK-MB,CK,LDH,ALT,and AST.Those indicators should be paid attention to in clinical practice.
作者
罗明海
段武琼
李聪
张森山
LUO Minghai;DUAN Wuqiong;LI Cong(Pediatric Ward No.3,Ankang City Central Hospital,Ankang Shaanxi 725000)
出处
《医学临床研究》
CAS
2023年第9期1357-1360,共4页
Journal of Clinical Research
