摘要
目的:分析重庆及周边地区蛇咬伤患者发生急性肾损伤的危险因素。方法:纳入2018年1月—2023年1月医院急诊科治疗的蛇咬伤患者156例,平均年龄为(51±16)岁。按照患者是否发生急性肾损伤,分为急性肾损伤组(26例)与非急性肾损伤组(130例)。收集并分析两组患者的临床资料,包括年龄、性别、院前时间、咬伤部位、白细胞计数、血红蛋白、肌红蛋白、心肌酶谱、肝功能、凝血功能等,并使用logistic逻辑回归模型分析与急性肾损伤相关的风险因素。结果:急性肾损伤组与非急性肾损伤组患者在院前时间、血红蛋白、肌酸激酶同工酶、性别、谷丙转氨酶、谷草转氨酶、凝血酶原时间、活化部分凝血活酶时间、肝功能异常、凝血功能异常方面进行比较,差异有统计学意义(均P<0.05);但两组患者在年龄、白细胞计数、血肌红蛋白、肌酸激酶及咬伤部位比较,差异无统计学意义(均P>0.05)。急性肾损伤组患者的院前时间较非急性肾损伤组患者长,差异有统计学意义(P<0.05);急性肾损伤组患者的肝功能和凝血功能异常情况相对较高,白细胞计数值均高于非急性肾损伤组患者,差异均有统计学意义(P<0.05);单因素logistic逻辑回归分析显示,性别、院前时间、白细胞计数、血红蛋白、肝功能及凝血功能差异均有统计学意义(P<0.05),多因素logistic回归分析显示在院前时间、肝功能异常及凝血功能异常均差异有统计学意义(P<0.05)。结论:性别、院前时间、白细胞计数、血红蛋白、肝功能及凝血功能是蛇咬伤诱发急性肾损伤的危险因素,而院前时间、肝功能异常及凝血功能异常是蛇咬伤诱发急性肾损伤的独立危险因素。
Objective: To analyze the risk factors associated with acute kidney injury in patients with snakebites in Chongqing and surrounding areas. Methods: From January 2018 to January 2023, 156 cases of snakebite patients treated in the emergency department of our hospital were included in the study. The average age of patients with snakebites was(51±16) years. The patients were divided into the acute kidney injury group(26 cases)and the non-acute kidney injury group(130 cases)based on whether acute kidney injury occurred. A comparative analysis was conducted on gender, age, pre-hospital time, bite site, leukocyte count, hemoglobin levels, myohaemoglobin, cardiac enzyme profile, liver function and coagulation function between the two groups. Additionally, logistic regression models were employed to analyze the relevant risk factors associated with acute kidney injury. Results: Between the acute kidney injury group and non-acute kidney injury group, hemoglobin, creatine kinase isoenzyme, gender, alanine aminotransferase, aspartate aminotransferase, prothrombin time, activated partial thromboplastin time, abnormal liver function and coagulation function(P<005). However, the two groups showed no difference in age, leukocyte count, haemoglobin, creatine kinase and bite site(P> 005).The pre-hospital time of patients with acute kidney injury was longer than that of patients with non-acute kidney injury(P<0.05). Acute kidney injury patients exhibited relatively higher rates of abnormal liver and coagulation function, as well as elevated leukocyte count, all with statistical significance(P<0.05). logistic regression analysis showed that gender, treatment time, leukocyte count, hemoglobin, liver function, and coagulation function were found to be statistical significance(P<0.05). Pre-hospital time, abnormal liver function, and coagulation function were found to be statistical significance(P<0.05). Conclusion: Gender, pre-hospital time, leukocyte count, hemoglobin, liver function, and coagulation function are risk factors for the development of acute kidney injury induced by snakebites. Furthermore, pre-hospital time, abnormal liver function and abnormal coagulation function are independent risk factors for acute kidney injury following snakebites.
作者
邓孝露
陈小雄
罗丽
刘明华
DENG Xiaolu;CHEN Xiaoriong;LUO Li;LIU Minghua(Department of Emergency,the First Affiliated Hospital of the Army Medical University,Chongqing,400038,China)
出处
《临床急诊杂志》
CAS
2024年第8期428-432,共5页
Journal of Clinical Emergency
基金
陆军毕业后医学教育教学改革研究重点项目(No:2023bjg102)。
关键词
蛇咬伤
急性肾损伤
危险因素
snake bites
acute kidney injury
risk factors
