广西医学

目的系统评价蜂蜇伤后急性肾损伤（AKI）的危险因素。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、万方数据知识服务平台、中国知网、维普资讯中文期刊服务平台、中国生物医学文献服务系统等数据库，纳入关于蜂蜇伤后AKI的危险因素的文献。对文献进行筛选、资料提取和质量评价后，采用RevMan 5.3软件进行Meta分析。结果共纳入16项病例对照研究，包含3 753例蜂蜇伤患者。Meta分析结果显示，外周血白细胞计数升高、外周血白细胞计数>20×109/L、贫血、年龄增长、蜂蜇伤至入院时间延长、蜂蜇伤数目增加、蜂蜇伤数目>30处、肉眼血尿、血清乳酸脱氢酶水平升高、血清肌红蛋白水平升高、血清白蛋白水平≤35 g/L是蜂蜇伤后AKI的危险因素（P<0.05）。结论外周血白细胞计数升高、外周血白细胞计数>20×109/L、贫血、年龄增长、蜂蜇伤至入院时间延长、蜂蜇伤数目增加、蜂蜇伤数目>30处、肉眼血尿、血清乳酸脱氢酶水平升高、血清肌红蛋白水平升高、血清白蛋白水平≤35 g/L可增加蜂蜇伤后AKI的发生风险。

Objective To systematically evaluate the risk factors for acute kidney injury (AKI) after wasp stings. Methods Literature related to the risk factors for AKI after wasp stings was enrolled by retrieving the databases of PubMed, Embase, Web of Science, The Cochrane Library, WanFang Data Knowledge Service Platform, China National Knowledge Infrastructure, VIP, and China Biology Medicine disc, etc. After literature screening, data extraction, and quality evaluation, the RevMan 5.3 software was used to perform Meta⁃analysis. Results A total of 16 case⁃control studies were enrolled, containing 3753 cases of patients with wasp stings. The results of Meta⁃analysis revealed that the elevation of peripheral blood white blood cell counts, peripheral blood white blood cell counts>20×109/L, anemia, growth of age, prolongation of wasp stings to hospital admission, increased number of wasp stings, number of wasp stings>30, gross hematuria, elevation of serum lactate dehydrogenase level, elevation of serum myoglobin level, serum albumin level≤35 g/L were the risk factors for AKI after wasp stings (P<0.05). Conclusion The elevation of peripheral blood white blood cell counts, peripheral blood white blood cell counts>20×109/L, anemia, growth of age, prolongation of wasp stings to hospital admission, increased number of wasp stings, number of wasp stings>30, gross hematuria, elevation of serum lactate dehydrogenase level, elevation of serum myoglobin level, serum albumin level≤35 g/L may increase the occurrence risk of AKI after wasp stings.