蜂蛰伤中毒致急性肾损伤的相关危险因素调查
- Author:
- No author available
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.1001-9391.2018.02.007
- Key Word:
- 蜂蛰伤;急性肾损伤;危险因素;流行病学
Abstract： 目的 调查蜂蛰伤中毒患者发生急性肾损伤(AKI)的相关危险因素.方法 于2014年1月至2016年12月,选择我院诊治的蜂蛰伤中毒患者164例,收集一般资料、入院24 h内实验室数据、住院时间和住重症监护室(ICU)时间、发生多器官功能障碍综合征(MODS)和死亡情况.根据患者是否发生AKI将其分为AKI组(120例)和非AKI组(44例),并对蜂蛰伤中毒发生AKI的流行病学情况和危险因素进行分析.结果 蜂蛰伤中毒患者AKI的发生率为26.83％,病死率为22.73％,并发MODS发生率为88.64％.多因素logistic回归分析显示,年龄大(OR=1.066,95％CI:1.052～1.109)、蛰伤数目多(OR=1.040,95％CI:1.009～1.072)、胡蜂蛰伤(OR =17.840,95％ CI:5.475～58.158)、MODS(OR =39.426,95％CI:9.155～169.791)以及入院24h内血白细胞(OR =1.160,95％CI:1.070～1.259)、血钾(OR =2.339,95％CI:1.123～4.871)、乳酸脱氢酶(OR=1.002,95％CI:1.001～1.003)、肌酸激酶同工酶(OR=1.015,95％CI:1.007～1.024)、肌红蛋白(OR=1.001,95％CI:1.000～1.001)、天冬氨酸转氨酶(OR=1.004,95％CI:1.001～1.007)、丙氨酸转氨酶(OR=1.010,95％CI:1.000～1.019)、超敏C反应蛋白(OR=1.042,95％CI:1.011～1.074)、尿蛋白(OR=3.472,95％CI:1.414～8.072)异常是蜂蛰伤致AKI的危险因素.结论 高龄、蛰伤数目越多、胡蜂蛰伤、MODS以及入院24h内血白细胞、血钾、乳酸脱氢酶、肌酸激酶同工酶、肌红蛋白等异常是蜂蛰伤致AKI发生的危险因素.
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