Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
Department of Clinical Pathology, Qena Faculty of Medicine, South Valley University, Egypt.
Am J Trop Med Hyg. 2022 Jan 10;106(3):962-966. doi: 10.4269/ajtmh.21-0090.
Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.
蝎子螫伤是一种危及生命的紧急情况，在热带和亚热带地区会导致严重的健康问题。本研究旨在探讨入院时血清生化参数与儿童蝎子螫伤后续发病率和死亡率的相关性。这是一项前瞻性、观察性和描述性研究，研究对象为 2019 年 4 月至 2019 年 9 月期间在急诊和重症监护病房就诊的蝎子螫伤儿童。记录并列表记录患者的人口统计学、临床和实验室发现。除了测定血乳酸、游离脂肪酸 (FFA) 和胰岛素水平外，所有患者均进行了常规检查。根据结局（幸存者和非幸存者）以及血糖水平（正常血糖组和高血糖组）对所有患者进行比较。共有 62 例蝎子蛰伤病例；平均年龄为 8.6 ± 3.2 岁。6 岁以上（74.2%）和男性（66.1%）患者比其他患者更容易受到影响。就严重程度而言，25.8%的患者出现器官功能障碍，40.3%的患者出现无器官功能障碍的全身表现，（33.9%）仅出现局部表现。与幸存者相比，非幸存者的血清葡萄糖和 FFA 明显更高。与正常血糖组相比，高血糖组的休克、惊厥、昏迷、心力衰竭和肺水肿更为常见。高血糖和 FFA 升高与严重蝎子螫伤有关。升高的 FFA 与心力衰竭、白细胞增多和高血糖密切相关。将血清葡萄糖和 FFA 添加到监测蝎子中毒严重程度的参数中可以帮助预测高危患者。
