[1]梁 旭,尚立清,魏道慧,等.湖北省潜江市某三甲医院蝮蛇咬伤继发组织坏死的影响因素及预测模型构建[J].医学信息,2026,39(05):57-61,71.[doi:10.3969/j.issn.1006-1959.2026.05.009]
　LIANG Xu,SHANG Liqing,WEI Daohui,et al.Influencing Factors and Prediction Model Construction of Tissue Necrosis Secondaryto Viper Bite in a Tertiary Hospital in Qianjiang City, Hubei Province[J].Journal of Medical Information,2026,39(05):57-61,71.[doi:10.3969/j.issn.1006-1959.2026.05.009]
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湖北省潜江市某三甲医院蝮蛇咬伤继发组织坏死的影响因素及预测模型构建()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年05期
页码:
57-61,71
栏目:
临床信息学
出版日期:
2026-03-01

文章信息/Info

Title:
Influencing Factors and Prediction Model Construction of Tissue Necrosis Secondaryto Viper Bite in a Tertiary Hospital in Qianjiang City, Hubei Province
文章编号:
1006-1959（2026）05-0057-06
作者:
梁 旭1; 尚立清2; 魏道慧3; 董赐成1; 张缘园1
1.潜江市中心医院急诊科，湖北 潜江 433100；2.新疆医科大学第二附属医院急诊科，新疆 乌鲁木齐 830000；3.潜江市中心医院消化内科，湖北 潜江 433100
Author(s):
LIANG Xu1;  SHANG Liqing2;  WEI Daohui3;  DONG Cicheng1;  ZHANG Yuanyuan1
1.Department of Emergency, Qianjiang Central Hospital, Qianjiang 433100, Hubei, China;2.Department of Emergency, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang, China;3.Department of Gastroenterology, Qianjiang Central Hospital, Qianjiang 433100, Hubei, China
关键词:
腹蛇咬伤; 组织坏死; 预测模型
Keywords:
Viper bite;  Tissue necrosis;  Predictive model
分类号:
R646
DOI:
10.3969/j.issn.1006-1959.2026.05.009
文献标志码:
A
摘要:
目的 探讨蝮蛇咬伤继发组织坏死的影响因素及预测模型构建。方法 回顾性分析2021年2月1日-2024年7月31日潜江市中心医院急诊科收治的81例蝮蛇咬伤患者的临床资料，所有患者入院后完善血常规、生化等实验室指标检查，根据组织是否发生坏死，分为组织坏死组和组织未坏死组，分析患者的一般基线资料，LASSO回归筛选自变量，多因素Logistic回归得出危险因素，基于R语言构建列线图，绘制ROC曲线、校准曲线、临床决策曲线。结果 蝮蛇咬伤患者发生组织坏死率为45.68%（37/81）。两组年龄、心率、季节、白细胞、中性粒细胞、淋巴细胞、ALT、AST、住院时间、SSS比较，差异有统计学意义（P＜0.05）。LASSO回归筛选的自变量为中性粒细胞、心率、SSS、住院时间，进一步通过Logistic回归分析明确中性粒细胞、心率、SSS为蝮蛇咬伤患者的独立危险因素。中性粒细胞、心率、SSS及三者联合的ROC曲线预测发生组织坏死的AUC依次为0.894、0.666、0.943、0.991。结论 中性粒细胞、心率、SSS是蝮蛇咬伤的独立危险因素，此次建模具有很高的拟合度和临床适应性，三者联合检测对蝮蛇咬伤患者发生组织坏死具有良好的预测价值。
Abstract:
Objective To explore the influencing factors and prediction model construction of tissue necrosis secondary to viper bite. Methods The clinical data of 81 patients with viper bites admitted to the emergency department of Qianjiang Central Hospital from February 1, 2021 to July 31, 2024 were retrospectively analyzed. All patients completed blood routine, biochemical and other laboratory indexes after admission. According to whether tissue necrosis occurred, they were divided into tissue necrosis group and non-necrotic group. The general baseline data of the patients were analyzed. LASSO regression was used to screen the independent variables, and multivariate Logistic regression was used to obtain the risk factors. The nomogram was constructed based on R language, and the ROC curve, calibration curve and clinical decision curve were drawn. Results The incidence of tissue necrosis was 45.68% (37/81) in patients bitten by viper. There were significant differences in age, heart rate, season, white blood cells, neutrophils, lymphocytes, ALT, AST, hospitalization time and SSS between the two groups (P<0.05). The independent variables screened by LASSO regression were neutrophils, heart rate, SSS and hospitalization time. Further Logistic regression analysis was used to determine that neutrophils, heart rate and SSS were independent risk factors for patients with viper bite. The AUC of neutrophil, heart rate, SSS and the combined ROC curve for predicting tissue necrosis were 0.894, 0.666, 0.943 and 0.991, respectively. Conclusion Neutrophils, heart rate, and SSS are independent risk factors for viper bites. This modeling has a high degree of fitting and clinical adaptability. The combined detection of the three has a good predictive value for tissue necrosis in patients with viper bites.

参考文献/References:

[1]Seifert SA,Armitage JO,Sanchez EE.Snake Envenomation[J].N Engl J Med,2022,386(1):68-78.[2]GBD 2017 Causes of Death Collaborators.Global, Regional, And National Age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2018,392(10159):1736-1788.[3]Longbottom J,Shearer FM,Devine M,et al.Vulnerability to snakebite envenoming:a global mapping of hotspots[J].Lancet,2018,392(10148):673-684.[4]刘梦龙,王海燕,周馨,等.高压氧联合负压创面治疗技术对早期蝮蛇咬伤的疗效观察[J].遵义医科大学学报,2022,45(3):383-386.[5]彭清生,付芬,周冬龙.蓝光照射治疗蝮蛇咬伤效果分析[J].中国烧伤创疡杂志,2024,36(3):201-204.[6]Pin L,Lutao X,Weijun F,et al.Ulnar artery pseudoaneurysm and compartment syndrome formation after snake bite to the left forearm[J].Clin Toxicol (Phila),2018,56(6):436-438.[7]Huang YT,Cheng F,Liu YT,et al.Genome-based analysis of virulence determinants of a Serratia marcescens strain from soft tissues following a snake bite[J].Future Microbiol,2018,13:331-343.[8]中国蛇伤救治专家共识专家组.2018年中国蛇伤救治专家共识[J].中华急诊医学杂志,2018,27(12):1315-1322.[9]Perea?觡ez A,Preciado LM,Rey-suárez P.Knowledge about Snake Venoms and Toxins from Colombia:A Systematic Review[J].Toxins (Basel),2023,15(11):658.[10]Oliveira AL,Viegas MF,Da silva SL,et al.The chemistry of snake venom and its medicinal potential[J].Nat Rev Chem,2022,6(7):451-469.[11]Casewell NR,Jackson TNW,Laustsen AH,et al.Causes and Consequences of Snake Venom Variation[J].Trends Pharmacol Sci,2020,41(8):570-581.[12]Gutiérrez JM,Calvete JJ,Habib AG,et al.Snakebite envenoming[J].Nat Rev Dis Primers,2017,3:17063.[13]Zuliani JP,Soares AM,Gutiérrez JM.Polymorphonuclear neutrophil leukocytes in snakebite envenoming[J].Toxicon,2020,187:188-197.[14]Resiere D,Mehdaoui H,Névière R,et al.Infectious Complications Following Snakebite by Bothrops lanceolatus in Martinique:A Case Series[J].Am J Trop Med Hyg,2020,102(1):232-240.[15]赵晓东,孙荣距,苏琴,等.乌司他丁对严重蝮蛇咬伤器官损害及全身炎症反应的抑制作用[J].中国急救医学,2011,31(8):676-679.[16]Chaisakul J,Khow O,Wiwatwarayos K,et al.A Biochemical and Pharmacological Characterization of Phospholipase A(2) and Metalloproteinase Fractions from Eastern Russell’s Viper (Daboia siamensis) Venom:Two Major Components Associated with Acute Kidney Injury[J].Toxins (Basel),2021,13(8):521.[17]曾宪华,覃双全,骆立晖.蝮蛇咬伤患者血清NLR、PLR水平与病情严重程度的相关性[J].医学临床研究,2022,39(3):356-362.[18]Kang S,Moon J,Chun B.Does the traditional snakebite severity score correctly classify envenomated patients?[J].Clin Exp Emerg Med,2016,3(1):34-40.[19]Fowler AL,Hughes DW,Muir MT,et al.Resource Utilization After Snakebite Severity Score Implementation?into Treatment Algorithm of Crotaline Bite[J].J Emerg Med,2017,53(6):854-861.[20]Wood D,Sartorius B,Hift R.Classifying snakebite in South Africa:Validating a scoring system[J].S Afr Med J,2016,107(1):46-51.

更新日期/Last Update: 1900-01-01