Research On The Variation Of Inflammatory Markers Due To Agkistrodon Halys Bite In Northern China

ObjectiveAfter Agkistrodon Halys bite, local inflammatory response, damage of organ function and MODS will increase patient morbidity and mortality. The snake venom enter the body, injure the vascular endothelium, promote the release of histamine and inflammatory mediators, make the body produce inflammatory response.. These series of process may play important role in pathogenesis due to Agkistrodon Halys bite. This paper probe the variation and clinical significance of inflammatory markers in the serum of patients due to Agkistrodon Halys bite in northern China.MethodWe select 224 patients with Agkistrodon Halys bite admitted from June 2011 to September 2014 in emergency room and divide them into 3 groups:mild, severe and critical..We extract blood from 3 different time(treatment for 0 days,2 days and 7 days) and compare them to 30 healthy samples. We detect TNF-α, IL-1, IL-6, HMGB1 WBC, CRP, PCT at different time by ELISA.or analyzer. Finally we compare the each set of data with statistical methods. Simultaneously, we make the correlation analysis with TNF-α, IL-1, IL-6, WBC and CRP.Result(1) Comparing 3 patient groups with different stages to health group:Treatment for 0 days and for 2 days:TNF-α, IL-1, HMGB1, WBC of patient groups are higher than healthy group(P<0.05). IL-6, CRP of mild group are higher than healthy group(P>0.05). IL-6, CRP of severe and critical groups are higher than healthy group(P<0.05). Treatment for 7 days:HMGB1 of patient groups are higher than healthy group(P<0.05). TNF-α, IL-1, IL-6, CRP of mild group and TNF-α, IL-6, WBC, CRP of severe group are almost down to healthy group(P>0.05). WBC of mild group decreases significantly, and they are lower than healthy group(P<0.05). IL-1 of severe group is higher than healthy group(P<0.05). TNF-α, IL-6, IL-1, WBC, CRP of critical group are still higher than healthy group(P<0.05). Only PCT of critical group rise(P<0.05).(2) Comparison of 3 patient groups with the same stages:PCT of severe group is higher than mild group (P>0.05). IL-6, CRP of severe group are higher than mild group of treatment for 7 days(P>0.05). The values of inflammatory markers of other groups with the same stages rise as the level of poisoning(P<0.05)..(3) Comparison of 3 different stages in the same patient groups:HMGB1 of treatment for 2 days is higher than 0 days(P<0.05). HMGB1 of treatment for 7 days are lower than 2 days(P<0.05), but still higher than 0 days(P>0.05). IL-1 of critical group of treatment for 2 days is higher than 0 days. IL-6 of critical group of treatment for 2 days is lower than 0 days, and that for 7 days is lower than that for 2 days(P>0.05). CRP and PCT of critical group decrease with the progress of treatment (P>0.05). Apart from these, other values of inflammatory markers of the same patient groups all decrease as the progress of treatment (P<0.05).(4) TNF-α, IL-1, IL-6 are positively related to the values of WBC, CRP.ConclusionWe find that the values of inflammatory markers vary dynamically as the level of bite poisoning and the progress of treatment. This show that inflammatory markers is one of main pathogenesis of Agkistrodon Halys bite. And they are related to the stage of patient’s condition. They will may assist in the evaluation of the stage of Agkistrodon Halys bite poisoning. Dynamic detection of inflammatory markers will be useful in evaluating and guiding treatment. These inflammatory markers provide new treatment ideas for patient due to Agkistrodon Halys bite. The detection of WBC and CRP is convenient. The sensitivity of TNF-α, IL-1, IL-6 is high. There are significant positive relations among the values. They can supplement each other in clinical monitoring and assess the treatment. PCT may be a predictor of MODS. It shows that the critical patients may infect bacteria seriously. In the future we may guide the application of antibiotics by the monitoring of PCT, improve efficacy and save the treatment costs.