摘 要: 探讨早期序贯性血液灌流治疗对急性蜂蜇伤横纹肌溶解症疗效的影响。 方法 回顾性分析2011年8月至2017年10月我院急诊科收治的145例群蜂蜇伤出现横纹肌溶解的患者,将其分为两组,A组:蜂蜇伤大于12 h后接受血液灌流,B组:蜂蜇伤<12 h进行早期血液灌流,比较两组患者的急性肾功能衰竭和多器官功能障碍综合征的发生率、死亡率、平均住院时间以及蜂蜇伤后第48 h、96 h血液主要生化指标及炎症因子IL-1β,IL-6变化。结果 与A组比较,B组急性肾损伤与多器官功能障碍综合征的发生率、死亡率均明显低(P<0.05),平均住院时间也较短;患者在蜂蜇伤后血清肌酸激酶、肌酸激酶同工酶、肌酐、血红蛋白、降钙素原、超敏C反应蛋白以及血清IL-1β,IL-6水平也均低于A组(P<0.05)。结论 早期序贯性血液灌流治疗能够减少蜂蛰伤急性肾损伤与多器官功能障碍综合征的发生率,明显下降炎性因子水平,改善患者预后。 |
关键词: 蜂蛰伤 血液灌流 横纹肌溶解(RM) 白介素-1β(IL-1β),白介素-6(IL-6) |
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基金项目: 十堰市科技局指导项目(编号:15Y25,磷酯酶A在蜂蛰伤多器官功能障碍综合征中的作用研究;编号:16Y28,IL-6基因多态性与胡蜂蛰伤MODS相关性的研究) |
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Clinical evaluation of early sequential hemoperfusion in treatment of rhabdomyolysis by acute bee stings |
Li Chang-sheng,Yang Xian-yi ,Chai Lin,Guo Hui,Duan Hui,Chen Ping,Xiao Min
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Department of Emergency,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,China
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Abstract: To investigate the effect of early sequential hemoperfusion on rhabdomyolysis by acute bee stings. Methods A total of 145 cases of rhabdomyolysis by bee stings admitted to the emergency department of our hospital from August 2011 to October 2017 were retrospectively analyzed, according to the starting time, the cases were divided into two groups: group A, hemoperfusion was taken after 12 hours of bee stings; and group B, hemoperfusion was taken within12 hours of bee stings, the incidence and mortality rate of acute kidney injury(AKI)and multiple organ dysfunction syndrome(MDOS), the average hospitalization time, the changes of main biochemical indicators and inflammatory factors including IL-1β, IL-6 at 48 h and 96 h after wasp stings were compared in between the two groups. Results The results showed that the incidences and mortality rates both in acute renal injury and multi-organ dysfunction syndrome in group B were all significantly lower than that of group A (P<0.05), the average hospitalization time was also shorter in group B. Meanwhile, the levels of serum creatine kinase, creatine kinase isoenzyme, creatinine, hemoglobin, calcitonin and hypersensitive c-reactive protein in group B were all lower than that of group A(P<0.05), as well as the levels of serum IL-1β, IL-6. Conclusion: The results suggested that early sequential hemoperfusion could reduce the incidence of acute renal injury and multiple organ dysfunction syndrome by bee stings, significantly lower the levels of inflammatory factors and improve the prognosis of stings . |
Keywords: bee stings rhabdomyolysis (RM) hemoperfusion interleukin-1β (IL1β) interleukin-6 (IL 6) |