蝮蛇咬伤患者血小板计数与病情严重程度的关系及对预后的影响

Relationship between platelet count and severity of patients with agkistrodon bite and its effect on prognosis

目的观察蝮蛇咬伤患者血小板计数与病情严重程度的关系,同时分析其对病情预后的影响。方法将所有蝮蛇咬伤患者分为血小板正常组和血小板减少组。比较2组患者入院时谷丙转氨酶(ALT)、血肌酐(Cr)、肌酸肌酶(CK)、氧合指数、C反应蛋白(CRP)、血沉(ESR)等临床指标;比较2组患者全身炎症反应综合征(SIRS)、多器官功能障碍综合征(MODS)的发生率;治疗后观察2组患者预后情况。结果2组患者入院时ALT、CK差异有统计学意义(P<0.05);血小板减少组患者SIRS、MODS的发生率显著高于血小板正常组,差异有统计学意义(P<0.05);血小板减少组患者预后较差,2组比较差异有统计学意义(P<0.05)。结论血小板减少的蝮蛇咬伤患者病情相对较重,更易出现SIRS、MODS,疾病预后也较差。

Objective To observe the correlation between platelet count and severity of agkistrodon bite,and its effect on the prognosis of the disease.Methods All patients with agkistrodon bite were divided into normal platelet group and thrombocytopenia group.The clinical indexes such as glutamic-pyruvic transaminase(ALT),serum creatinine(Cr),creatine kinase(CK),oxygenation index and C reactive protein(CRP) and erythrocyte sedimentation(ESR) were compared between the two groups.Meanwhile,the incidence of systemic inflammatory response syndrome(SIRS) and multiple organ dysfunction syndrome(MODS)in both groups were compared.The prognosis of the two groups was observed after treatment.Results There were significant differences in ALT and CK levels in two groups ( P <0.05).The incidence of SIRS,MODS in the thrombocytopenia group were higher than that of normal platelet group ( P <0.05).Patients in thrombocytopenia group had a poor prognosis,the between-group difference was statistically significant( P <0.05).Conclusion Being prone to occurring SIRS and MODS,agkistrodon bite patients with thrombocytopenia are usually in more serious condition,and have poor prognosis.