Wang Fu-Zhen, Xiang Shi-Hong, Lin Sen-Qing, Qian Feng-Qi, Zhang Qiu-Xia, Geng Ming-Hui, Deng Jin-Xiu, Wu Sen-Chao
Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian 364000, People's Republic of China.
Department of Nephrology, Xuanhan County People's Hospital, Dazhou, Sichuan, 636150, People's Republic of China.
Int J Gen Med. 2024 Nov 26;17:5535-5546. doi: 10.2147/IJGM.S479291. eCollection 2024.
To enhance the understanding of rhabdomyolysis (RM) caused by snakebites and to promptly identify and intervene in the risk factors associated with RM.
A retrospective analysis involving 209 snakebite victims who visited our hospital for snakebite cases was conducted. Among these, 43 were related to RM, while 166 did not exhibit RM (NRM). The clinical characteristics, treatment, and prognostic outcomes of both groups were statistically analyzed, with the aim of interpreting the risk factors associated with snakebites concurrent with RM through logistic regression analysis.
Snakebite incidents commonly manifest during the summer and autumn seasons, predominantly affecting middle-aged and elderly populations, with injuries mostly occurring in the limbs. Creatine kinase (CK), CK isoenzyme MB, and lactate dehydrogenase indicators exhibited significantly elevated levels in the RM group compared to the NRM group ( < 0.05). Moreover, the RM Group displayed heightened susceptibility to complications such as osteofascial compartment syndrome, multiple organ dysfunction (MODS), acute kidney injury, etc. ( < 0.05). Debridement and blood purification procedures were more frequently administered to the RM group in comparison to the NRM group ( < 0.05). Notably, visitation beyond 6 hours post-bite and hemoglobin levels below 90 mg/dl emerged as independent risk factors for those with RM following snakebites, while female gender and albumin levels >40 g/L were identified as protective factors against such occurrences.
Snakebite victims with RM have more severe clinical conditions, necessitating prolonged treatment duration, and exhibit heightened mortality rates in comparison to those without RM.
增强对蛇咬伤所致横纹肌溶解症（RM）的认识，并及时识别和干预与RM相关的危险因素。
对我院收治的209例蛇咬伤患者进行回顾性分析。其中，43例与RM相关，166例未出现RM（非RM组）。对两组患者的临床特征、治疗情况及预后进行统计学分析，旨在通过逻辑回归分析解读与蛇咬伤并发RM相关的危险因素。
蛇咬伤事件常见于夏秋季节，主要影响中老年人群，损伤多发生在四肢。与非RM组相比，RM组的肌酸激酶（CK）、CK同工酶MB及乳酸脱氢酶指标显著升高（<0.05）。此外，RM组发生骨筋膜室综合征、多器官功能障碍综合征（MODS）、急性肾损伤等并发症的易感性更高（<0.05）。与非RM组相比，RM组更频繁地接受清创和血液净化治疗（<0.05）。值得注意的是，咬伤后超过6小时就诊以及血红蛋白水平低于90mg/dl是蛇咬伤后发生RM患者的独立危险因素，而女性性别及白蛋白水平>40g/L被确定为预防此类情况的保护因素。
与未发生RM的蛇咬伤患者相比，发生RM的蛇咬伤患者临床病情更严重，治疗时间更长，死亡率更高。
