小儿蜂蜇伤中毒后致急性肾损伤的相关因素分析

doi:10.3969/j.issn.1671-7171.2023.09.021

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Abstract 【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 (Ca²⁺),carbon dioxide combining power (CO₂CP),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≥14.095×10⁹/L,K⁺≥5.5 mmol/L,Scr≥129.490 μmol/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.

Key words： Bites and Stings Bees Acute Kidney Injury/CO Root Cause Analysis

Received: 18 August 2022

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R646.5

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	Articles by authors
	LUO Minghai
	DUAN Wuqiong
	LI Cong
	et al

Cite this article:

LUO Minghai,DUAN Wuqiong,LI Cong, et al. Analysis of Factors Related to Acute Kidney Injury after Bee Sting Poisoning in Children[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(9): 1357-1360.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.09.021 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I9/1357

[1] 李莉,夏羽茜,李馨欣,等. 蜂蛰伤发病机制的研究进展[J].海南医学,2018,29(20):2940-2942.
[2] WITHARANA RA,DISSANAYAKE A,KARUNARATNE I,et al. A rare case of micro-angiopathic hemolytic anemia due to envenoming by giant asian honey bee (apis dorsata)[J].Wilderness Environ Med,2021,32(3):340-343.
[3] 冯云霞,张学鹏,陈硕,等. 蜂蜇伤患者血清降钙素原水平及其预测急性肾损伤的价值[J].中国急救医学,2020,40(7):610-613.
[4] FLISER D,LAVILLE M,COVIC A,et al. A European Renal Best Practice (ERBP) position statement on the Kid-ney Disease Improving Global Outcomes (KDIGO) clinical prac-tice guidelines on acute kidney injury:part 1: definitions,conser-vative management and contrast-induced nephropathy[J].NephrolDial Transplant,2012,27(12):4263-4272.
[5] 中国毒理学会中毒与救治专业委员会,中华医学会湖北省急诊医学分会,湖北省中毒与职业病联盟,等. 胡蜂螫伤规范化诊治中国专家共识[J].中华危重病急救医学,2018,30(9):819-823.
[6] HUGHES R L. A fatal case of acute renal failure from envenoming syndrome after massive bee attack: a case report and literature review[J].Am J Forensic Med Pathol,2019,40(1):52-57.
[7] TOLEDO LFM,MORRE DCBC,CAIXETA DMDL,et al. Multiple bee stings,multiple organs involved: a case report[J].Rev Soc Bras Med Trop,2018,51(4):560-562.
[8] CHEN T H,LIAO W T,CHEN C S,et al. An Envenoming Syndrome from Massive Vespa Stings Induces Multiple Organ Failure[J].Insects,2020,11(4):219.
[9] 席秋萍,陈宗英,方文燕,等. 蜂蛰伤中毒致急性肾损伤的相关危险因素调查[J].中华劳动卫生职业病杂志,2018,36(2):92-94.
[10] 张琼,王彩凤,梁哲. 黄蜂蛰伤临床特点及急性肾损伤的危险因素分析[J].现代泌尿外科杂志,2019,24(11):944-947.
[11] SRISUWAEN P,SRISUMA S,SRIAPHA C,et al. Clinical effects and factors associated with adverse clinical outcomes of hymenopteran stings treated in a Thai Poison Centre: a retrospective cross-sectional study[J].Clin Toxicol (Phila),2022,60(2):168-174.
[12] 李大欢,王天中,潘萌,等. 肌酸激酶同工酶与中毒严重程度评分对胡蜂蜇伤患者预后的预测价值研究[J].中华危重病急救医学,2021,33(1):105-108.
[13] VIKRANT S,JARYAL A,GUPTA D,et al. Parashar A.Epidemiology and outcome of acute kidney injury due to venomous animals from a subtropical region of India[J].Clin Toxicol (Phila), 2019,57(4):240-245.
[14] 刘蓉芝,胡庆,唐勇. CVVH联合HP对蜂蛰伤致多器官功能障碍综合征患者心肌酶和肝肾功能水平的影响[J].中南医学科学杂志,2020,48(1):93-96.