糖皮质激素联合早期序贯性血液灌流治疗急性蜂蜇伤致横纹肌溶解症的效果及对心肌损伤标志物、炎性因子水平的影响

Effect of glucocorticoid combined with early sequential hemoperfusion on rhabdomyolysis caused by acute bee sting and its influences on myocardial injury markers and inflammatory factor levels

目的分析糖皮质激素联合早期序贯性血液灌流(HP)治疗急性蜂蜇伤致横纹肌溶解症(RM)的临床效果。方法选取2019年1月至2021年1月的40例急性蜂蛰伤致RM患者为研究对象,按随机数字表法将其分为对照组(n=20,早期序贯性HP治疗)和观察组(n=20,糖皮质激素联合早期序贯性HP治疗)。比较两组的治疗效果。结果治疗后,观察组的肌酐、尿素氮、尿酸水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Myo)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平低于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论糖皮质激素联合早期序贯性HP治疗急性蜂蛰伤致RM的效果显著,能够减缓心、肾功能损伤,降低机体炎性因子水平,改善患者预后,值得临床推广。

Objective To analyze the clinical effect of glucocorticoid combined with early sequential hemoperfusion(HP)in the treatment of rhabdomyolysis(RM)caused by acute bee sting.Methods From January 2019 to January 2021,40 patients with RM caused by acute bee sting were selected as the research objects.According to the random number table method,the patients were divided into control group(n=20,early sequential HP treatment)and observation group(n=20,glucocorticoid combined with early sequential HP treatment).The therapeutic effects of the two groups were compared.Results After treatment,the levels of creatinine,urea nitrogen and uric acid in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of creatine kinase(CK),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB)and myoglobin(Myo)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of interleukin-1β(IL-1β),interleukin-6(IL-6),procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Glucocorticoid combined with early sequential HP is effective in the treatment of RM caused by acute bee sting,it can slow down the damage of heart and kidney function,reduce the levels of inflammatory factors and improve the prognosis of patients,which is worthy of clinical promotion.