摘要
目的探讨重度蜂蛰伤致急性肾损伤(AKI)患者的临床特征及危险因素,为临床提供依据。方法回顾性分析杭州市中医院2018年1月至2020年12月收治的重度蜂蜇伤患者资料,根据是否合并AKI分为AKI组26例和非AKI组54例,比较两组一般情况、实验室指标、住院时间及费用,对AKI患者进行亚组分析,通过多因素Logistic回归分析影响预后的危险因素。结果符合纳入标准的患者有80例,其中男女比例为5∶3,平均年龄(58.1±11.9)岁。蜂蜇伤多发生于7~11月,其中4例(5.0%)死亡,2例(2.5%)进入终末期肾脏病。与非AKI组相比,AKI组患者住院时间更长,日平均费用更高,差异有统计学意义(P<0.01);两组入院24 h内实验室指标比较,差异有统计学意义(P<0.05)。AKI亚组:多因素Logistic回归分析显示,患者年龄>60岁、血乳酸>4 mmol/L是蜂蜇伤致AKI患者疾病进展的独立危险因素(P<0.05)。结论蜂蛰伤所致AKI患者病情凶险,经济负担重,蜇伤后应密切监测血常规、肝肾功能等指标,若合并高龄及血乳酸高者应警惕疾病恶化。
Objective To explore the clinical characteristics and risk factors in patients with acute kidney injury(AKI)caused by severe bee sting injury,and to provide clinical evidence.Methods A retrospective analysis was conducted on patients with severe bee stings admitted to the Hangzhou Chinese Medical Hospital from January 2018 to December 2020.According to whether the bee stings were complicated with AKI,they were divided into the AKI group(n=26)and the non-AKI group(n=54).The general conditions,laboratory indicators,hospital stay,and cost were compared between the two groups.Subgroup analysis was conducted in AKI patients.Multivariate Logistic regression analysis was conducted to investigate the risk factors for prognosis.Results A total of 80 patients met the inclusion criteria.The male to female ratio was 5∶3,and average age was(58.1±11.9)years old.Bee stings mostly occurred from July to November,among which 4 patients(5.0%)died,and 2 patients(2.5%)got end-stage renal disease.Compared with the non-AKI group,the AKI group had a longer hospital stay and a higher average daily cost,with statistically significant differences(P<0.01).There were statistically significant differences in laboratory indicators within 24 hours after hospitalization between the two groups(P<0.05).In the AKI subgroup,multivariate logistic regression analysis showed that age>60 years old and blood lactate>4 mmol/L were independent risk factors for disease progression in patients with AKI caused by bee stings(P<0.05).Conclusion Patients with AKI caused by bee stings have a dangerous condition and a heavy economic burden.After sting,blood count,liver function,renal function and other indicators should be closely monitored.Patients with advanced age and high blood lactic acid should be alert to the deterioration of disease.
作者
黄加力
俞东容
胡日红
姚国明
王利峰
HUANG Jiali;YU Dongrong;HU Rihong;YAO Guoming;WANG Lifeng(Department of Nephrology,Hangzhou Dingqiao Hospital,Hangzhou 310021,China;Department of Nephrology,Hangzhou Chinese Medical Hospital,Hangzhou 310007,China)
出处
《中国现代医生》
2021年第33期109-112,共4页
China Modern Doctor
基金
浙江省公益技术应用研究计划项目(LGF19H270007)。
关键词
蜂蜇伤
急性肾损伤
危险因素
预后
Bee sting injury
Acute kidney injury
Risk factors
Prognosis
