蜂蜇伤致多器官功能障碍综合征患者实验室检测结果分析

目的通过对蜂蜇伤致多器官功能障碍综合征（MODS）患者各实验室检测结果的分析，探讨实验室结果在病情的判断和治疗中的意义。方法对21例蜂蜇伤致MODS患者刚入院时、入院第4天、临床治愈出院前的血常规、凝血四项、心肌损伤标志物、肝功能、肾功能等各项检查结果进行回顾性分析。结果刚入院时的检测结果中白细胞（WBC）、肌钙蛋白、肌红蛋白、凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）水平均100％升高，转氨酶80％升高，总胆红素（TBIL）70％升高，30％的患者BUN、Cr升高，其中25％m现急性肾功能衰竭。人院第4天30％～40％的患者出现Hb、PLT的下降，BUN、Cr水平与刚入院时比较明显升高（P〈0．01）。出院前Hb、Cr水平与正常参考范同比较仍有差异，其余结果则全部在正常参考范同之内。结论蜂蜇伤MODS患者最易受损的是心肌和凝血系统．肾功能受损较少，但病情最为凶险，恢复所需时间也最长，因而及时准确的实验室检查是判断MODS患者病情发展及疗效的重要手段。

Analysis of laboratory detection results in patients with MODS caused by bee sting

Objective To explore the significance of laboratory results in the condition of judgment and treatment, through the analysis of laboratory detection results in patients with MODS caused by bee sting. Methods The test results of routine blood, coagulation four indices, myocardial injury markers, liver function and kidney function of 21 cases of patients with MODS caused by bee sting were retrospectively analyzed when they were just admitted to hospital, the forth day and clinical cure before discharge. Results When just be in hospital, the levels of WBC, cTn, Mb, PT and APTT were sure increased with the rate of 100%. The levels of ALT and AST were sure increased with the rate of 80%, TBIL were sure increased with the rate of 70%, BUN and Cr of the patients with the rate of 30% were increased in which 25% patients had acute renal failure. When be in hospital on the forth day, the levels of Hb and PLT in patients with the rate of 35% decreased. The levels of BUN and Cr were significantly higher than that in first day in hospital (P < 0.01). The levels of Hb and Cr before the admission of hospital had the differences compared with the normal reference range, while other results were all in the normal reference range. Conclusion The most easy damage of patients with MODS caused by bee sting are geart and blood coagulation system, kidney function are less damaged, but the disease condition is most serious, and it needs a long time to recover, so timely and accurate laboratory detection are the important means for judging the illness development and curative effect of the MODS patients.