Li Dahuan, Wang Tianzhong, Pan Meng, Zhang Honghua, Zhang Guoxiu
Department of Emergency, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan, China.
Department of Emergency, Jiyuan People's Hospital, Jiyuan 454650, Henan, China. Corresponding author: Zhang Guoxiu, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Jan;33(1):105-108. doi: 10.3760/cma.j.cn121430-20200810-00571.
To explore the predictive value of MB isoenzyme of creatine kinase (CK-MB) and poisoning severity score (PSS) in the clinical prognosis of patients with wasp sting.
A retrospective study was conducted. The clinical data of patients who were stung by wasps admitted to emergency department of the First Affiliated Hospital of Henan University of Science and Technology from July 2017 to November 2019 were collected. The 24-hour acute physiology and chronic health evaluation II (APACHE II), CK-MB and PSS scores of the patients were collected after admission, and 28-day outcome was recorded. Spearman correlation analysis method was used to analyze the correlation between CK-MB and PSS score. Logistic regression model was used to construct joint predictors, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of various indicators for 28-day prognosis of patients with wasp stings.
Finally 90 patients were included in the analysis. There were 67 patients survived at 28 days, and 23 dead with the 28-day mortality of 25.6%. APACHE II score, CK-MB and PSS score in the death group were significantly higher than those in the survival group [APACHE II score: 19.7±2.7 vs. 13.7±2.3, CK-MB (U/L): 183 (151, 243) vs. 36 (21, 75), PSS score: 17.7±2.6 vs. 9.3±4.5, all P < 0.01]. The correlation analysis showed that CK-MB and PSS score were positively correlated (r = 0.843, P < 0.01). Logistic regression model fitted CK-MB and PSS score, and Hosmer-Lemeshow test showed that the model fitted well. ROC curve analysis showed that the area under ROC curve (AUC) of CK-MB for predicting 28-day outcome was 0.957, the sensitivity was 91.3%, and the specificity was 88.1%; the AUC of PSS score was 0.908, the sensitivity was 91.3%, and the specificity was 90.8%. The AUC of CK-MB combined with PSS score was 0.964, the sensitivity was 100%, and the specificity was 79.4%, indicating that CK-MB combined with PSS score had higher predictive value and higher sensitivity for 28-day prognosis of patients with wasp sting.
High CK-MB level and high PSS score in early stage of wasp sting injury indicate poor prognosis. Both CK-MB and PSS score can be used as predictors for predicting the prognosis of patients with wasp stings. In addition, CK-MB combined with PSS score have greater predictive value.
探讨肌酸激酶同工酶（CK-MB）及中毒严重程度评分（PSS）对黄蜂蜇伤患者临床预后的预测价值。
进行一项回顾性研究。收集2017年7月至2019年11月在河南科技大学第一附属医院急诊科就诊的黄蜂蜇伤患者的临床资料。患者入院后收集其24小时急性生理与慢性健康状况评分II（APACHE II）、CK-MB及PSS评分，并记录28天结局。采用Spearman相关分析方法分析CK-MB与PSS评分之间的相关性。使用Logistic回归模型构建联合预测指标，并绘制受试者工作特征（ROC）曲线以评估各指标对黄蜂蜇伤患者28天预后的预测价值。
最终纳入分析90例患者。28天存活67例，死亡23例，28天死亡率为25.6%。死亡组的APACHE II评分、CK-MB及PSS评分均显著高于存活组[APACHE II评分：19.7±2.7 vs. 13.7±2.3，CK-MB（U/L）：183（151，243）vs. 36（21，75），PSS评分：17.7±2.6 vs. 9.3±4.5，均P<0.01]。相关性分析显示CK-MB与PSS评分呈正相关（r = 0.843，P<0.01）。Logistic回归模型拟合CK-MB与PSS评分，Hosmer-Lemeshow检验显示模型拟合良好。ROC曲线分析显示，CK-MB预测28天结局的ROC曲线下面积（AUC）为0.957，灵敏度为91.3%，特异度为88.1%；PSS评分的AUC为0.908，灵敏度为91.3%，特异度为9
