蛇咬伤患者血清CRP、凝血功能指标变化及其与病情严重程度的关系

Changes of serum CRP and coagulation function indexes in snakebite patients and their relationship with disease severity

目的:探究蛇咬伤患者血清C反应蛋白(CRP)、凝血功能指标变化及其与病情严重程度的关系。方法:选择2017年1月~2019年12月来我院就诊的被毒蛇咬伤的患者157例,根据患者病情严重程度分为轻型组(n=99例)、重型组(n=31例)、危重型组(n=27例),比较三组患者炎性因子水平[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、凝血功能[凝血酶原时间(PT),凝血酶时间(TT),活化部分凝血酶时间(APTT)及纤维蛋白原(FIB)]、肝功能[谷丙转氨酶(ALT)、天门冬氨酸氨基转移(AST)]、肾功能[尿素氮(BUN)、肌酐(Cr)]水平,探究炎性因子水平、凝血功能指标、肝肾功能指标与病情严重程度关系。结果:三组间的CRP、WBC、IL-6、PT、APTT、TT、FIB、ALT、AST、Cr、BUN比较,差异差异有统计学意义;且危重型组患者的CRP、WBC、IL-6、PT、APTT、TT、ALT、AST、Cr、BUN水平均高于轻型组及重型组,FIB水平均低于轻型组及重型组;患者的CRP、WBC、IL-6、PT、APTT、TT、ALT、AST、Cr、BUN水平与病情严重程度均呈正相关;FIB水平与与病情严重程度呈负相关。结论:蛇咬伤患者普遍存在炎性反应、凝血功能异常、肝肾功能异常等情况,CRP水平、凝血功能及肝肾功能指标对判断患者病情严重程度有重要参考价值。

Objective To explore the changes of serum C-reactive protein(CRP)and coagulation function indexes in snakebite patients and their relationship with disease severity.Methods A total of 157 patients who were bitten by poisonous snakes and treated in the hospital from January 2017 to December 2019 were enrolled.According to disease severity,they were divided into mild group(n=99),severe group(n=31)and critical group(n=27).The levels of inflammatory factors[white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6)],coagulation function indexes[prothrombin time(PT),thrombin time(TT),activated partial thrombin time(APTT),fibrinogen(FIB)],liver function indexes[alanine aminotransferase(ALT),aspartate transaminase(AST)]and kidney function indexes[blood urea nitrogen(BUN),creatinine(Cr)]were compared among the three groups.The relationship between inflammatory factors,coagulation function indexes,liver-kidney function indexes and disease severity was explored.Results The differences in CRP,WBC,IL-6,PT,APTT,TT,FIB,ALT,AST,Cr and BUN among the three groups were statistically significant.CRP,WBC,IL-6,PT,APTT,TT,ALT,AST,Cr and BUN in critical group were higher than those in mild group and severe group,while FIB was lower than that in mild group and severe group.CRP,WBC,IL-6,PT,APTT,TT,ALT,AST,Cr and BUN levels were positively correlated with disease severity,while FIB level was negatively correlated with it.Conclusion There are general situations such as inflammatory response,abnormal coagulation function and liver-kidney function in snakebite patients.CRP level,coagulation function and liver-kidney function indexes are of important reference value for determining disease severity of patients.