胡蜂蜇伤患者过敏反应的临床特征及其对预后的影响

Clinical characteristics of allergic reactions in patients with wasp stings and its influence on prognosis

目的总结胡蜂蜇伤患者过敏反应的临床特征并探索其对预后的影响。方法回顾性分析汉中市中心医院2014年7月至2021年8月收治的575例胡蜂蜇伤患者的临床资料,根据纳入及排除标准最终纳入434例,并将出现过敏反应的404例患者根据临床结局分为存活组与死亡组,分析其过敏反应的临床特征及其对预后的影响。结果胡蜂蜇伤患者的过敏反应发生率为93.09%。404例发生过敏反应的患者中,94.06%出现皮肤系统过敏反应,42.82%出现循环系统过敏反应,41.34%出现消化系统过敏反应,5.94%出现呼吸系统过敏反应。女性患者的消化系统表现占比高于男性(P<0.05)。出现过敏反应患者中,2.48%涉及4个系统,18.81%涉及3个系统,38.86%涉及2个系统,39.85%涉及1个系统;其中36.39%为Ⅰ级过敏反应,52.23%为Ⅱ级过敏反应,11.39%为Ⅲ级及以上过敏反应。Ⅲ级及以上过敏反应患者发生蜇伤创面数>30处的占比高于Ⅰ、Ⅱ级过敏反应患者(P<0.05)。存活组与死亡组发生循环及呼吸系统症状、4个及1个系统过敏表现、Ⅲ级及以上程度和Ⅰ级的过敏反应占比比较,差异具有统计学意义(P<0.05)。结论胡蜂蜇伤患者的过敏反应发生率较高,其中以皮肤系统表现最常见,其次为循环、消化系统表现,女性比男性患者更易出现消化系统表现。蜇伤创面数>30处患者更易出现Ⅲ级及以上程度过敏反应。胡蜂蜇伤后发生Ⅲ级及以上程度过敏反应、4个系统过敏症状或呼吸、循环系统过敏症状患者的死亡率较高。

Objective To summarize the clinical characteristics of allergic reactions in patients with wasp stings and to explore its influence on prognosis.Methods The clinical data of 575 patients with wasp stings admitted in Hanzhong Central Hospital from July 2014 to August 2021 were retrospectively analyzed.According to the inclusion and exclusion criteria,434 patients were finally included,404 patients with allergic reactions were divided into survival group and death group according to clinical outcome,and the clinical characteristics of allergic reactions and its influence on prognosis were analyzed.Results The incidence of allergic reactions in patients with wasp stings was 93.09%.Among the 404 patients with allergic reactions,94.06%had skin system allergic reactions,42.82%had circulatory system allergic reactions,41.34%had digestive system allergic reactions,and 5.94%had respiratory system allergic reactions.The proportion of digestive system manifestations in female patients was higher than that in male patients(P<0.05).Among the patients with allergic reactions,2.48%involved 4 systems,18.81%involved 3 systems,38.86%involved 2 systems,and 39.85%involved 1 system;among them,36.39%were gradeⅠallergic reactions,52.23%were gradeⅡallergic reactions,and 11.39%were gradeⅢand above allergic reactions.The proportion of patients with gradeⅢand above allergic reactions with the number of sting wounds>30 was higher than that of patients with gradeⅠallergic reactions and gradeⅡallergic reactions(P<0.05).There were statistically significant differences in the proportions of circulatory and respiratory system symptoms,allergic manifestations of 4 and 1 systems,and allergic reactions of gradeⅢand above and gradeⅠbetween the survival group and the death group(P<0.05).Conclusion The incidence of allergic reactions in patients with wasp stings is higher,with the skin system being the most common manifestation,followed by circultory and digestive system.Women are more likely to have digestive system manifestations than men.patients with the number of sting wounds>30 are more likely to experience gradeⅢand above allergic reactions.Patients with gradeⅢand above allergic reactions,allergic symptoms of 4 systems or respiratory and circulatory system allergic symptoms after wasp stings had higher mortality.