SAA等指标联合检测在2种血循毒蛇咬伤中的诊断价值

Diagnostic value of combination test for SAA and other indexes in two circulating toxin snake bite

目的:探讨血清淀粉样蛋白A(SAA)等指标联合检测对2种血循毒蛇咬伤的诊断价值。方法:共110例患者入选为研究对象,其中蝰蛇咬伤28例、竹叶青蛇咬伤82例。在治疗前2h内即时抽血和在治疗后第1天空腹抽血检测这些患者的sAA等6项指标,并将检测结果在治疗前后和2种毒蛇之间作出比较。结果:蝰蛇咬伤治疗前s从、超敏c反应蛋白(h-CRP)、白细胞(WBC)、中性粒细胞(NEUT)和D-二聚体(D-D)均值高于参考区间上限、纤维蛋白原(Fib)均值低于参考区间下限,各项指标均有较高的阳性率;治疗后第1天除Fib外,其它5项指标均值和阳性率均比治疗前升高。竹叶青蛇咬伤治疗前sAA、h-cRP、WBC、NEUT和Fib均值均落在参考区间、D-D均值高于参考区间上限;治疗后第1天Fib均值比治疗前明显降低,其它5项指标均值均比治疗前明显升高;除h-CRP外,其它5项指标阳性率均明显高于治疗前。竹叶青蛇咬伤治疗前的sAA、h-CRP、WBC、NEUT和D-D均值均明显低于蝰蛇咬伤(P<0.05或P<0.01),Fib均值明显高于蝰蛇咬伤(P<0.05),6项指标阳性率亦明显低于蝰蛇咬伤(P<0.01);治疗后第1天的sAA、h-cRP、NEUT和D-D均值升高的程度不如蝰蛇咬伤(P<0.05)。结论:蝰蛇咬伤和竹叶青蛇咬伤患者在治疗前和治疗后第1天均可出现炎症反应和凝血功能异常,但蝰蛇咬伤比竹叶青蛇咬伤这些中毒表现更严重,sAA等指标联合检测对2种血循毒蛇咬伤有较好的诊断价值。

Objective:To explore the diagnostic value of combination test for serum amyloid A (SAA)and other indexes in 2 circulating toxin snake bite.Methods:The selected study objects were 110 cases and the viper bite was 28cases and the trimeresurus gramineus bite was 82 cases.The SAA and other 6 indexes were detected in these patients,the blood was drew in time before treatment in 2 hours and after treatment on the first day.The tested results were compared before and after treatment and between 2 snakes.Results:The mean of SAA,high sensitivity C-reactive protein (h-CRP),white blood cell (WBC),neutrophile granulocyte (NEUT)and D-dimer (D-D)were high to the upper limit of reference block and the fibrinogen (Fib)mean was low to the lower limit of reference block and the various index had all higher Positive rate before treatment for viper bite.Besides Fib,the mean and positive rate of other 5 indexes after treatment first day was higher in contrast to pei-treatment for viper bite.The mean ofSAA,h-CRP,WBC,NEUT and Fib was within the reference block and the D-D mean was high to the upper limit of reference block before treatment for trimeresurus gramineus bite.The mean of Fib was apparently low and the mean of other 5indexes was high and the positive rate of other 5indexes besides h-CRP was apparently high after treatment first day in contrast to before treatment for trimeresums gvamineus bite.The mean ofSAA,h-CRP,W-BC, NEUT and D-D before treatment in trimeresurus gramineus bite was low (P<0.05 or P<0.01)and Fib was apparently high (P<0.05)and the positive rate of 6indexes was lower (P<0.01)compared with the viper bite.The raised degree of mean ofSAA,h-CRP,NEUT and D-D after treatment first day in trimeresurus gramineus bite was not equal to the viper bite (P<0.05).Gonclusion:The patients with viper bite and trimeresums gramineus bite before treatment and after treatment first day showed the inflammatory reaction and blood coagulation function abnormality but these toxic expressions of viper bite are more severe in contrast to the trimeresurus gramineus bite.The combination tests of SAA and other indexes have certain diagnostic value for 2 circulating toxin snake bite.