Study On The Correlation Between Blood Cell Parameter Analysis And The Severity Of Venomous Snake Bite

Objective:To explore the correlation between blood cell parameters and the severity of snake bite,and to find fast and objective indicators to provide basis for judging the condition of patients with snake bite.Methods:A retrospective analysis was made on 132 patients with snake bite treated in the Affiliated Hospital of North Sichuan Medical College from May 2018 to October 2021.The general information of the patients,such as age,gender,bite location,bite to admission time,as well as vital signs such as blood pressure,heart rate,respiration and body temperature at admission,were collected,and the wound condition,clinical symptoms and laboratory data were recorded,(1)All cases were divided into mild group,moderate group and severe group according to the severity.The general data and laboratory data of patients in each group were compared,and the variables with statistically significant difference were analyzed by multivariate logistic regression.At the same time,the NLR,PLR and SII values of each group were calculated and the differences between groupswere compared.Spearman correlation analysis was used to evaluate the correlation between blood cell parameters and disease severity,and then the receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of different indexes in patients with severe snake bite;(2)According to the damage of liver function,the patients were divided into normal liver function group and liver function damage group.The inter group differences of NLR,PLR and SII between the two groups were compared.The statistically different indexes were drawn the receiver operating characteristic curve(ROC),and the diagnostic value of this index in predicting liver function damage in patients bitten by poisonous snakes was evaluated.Results:(1)The values of platelet and PLR in mild group were higher than those in moderate group and severe group,and those in moderate group were higher than those in severe group(P<0.05);The lymphocytes in severe and moderate groups were lower than those in mild group,and the difference was statistically significant(P<0.05);Neutrophils in severe group were higher than those in mild group,and the difference was statistically significant(P<0.05);NLR severe group and moderate group were higher than mild group,the difference was statistically significant(P<0.05);SII in severe group was lower than that in mild group and moderate group,and the difference was statistically significant(P<0.05).(2)Spearman correlation analysis showed that neutrophils and NLR were positively correlated with SSS score of patients with snake bite(r=0.313,0.377,P<0.01,P<0.001);Platelet,lymphocyte,PLR and SII were negatively correlated with SSS score(r=-0.789,-0.289,-0.533,-0.319,P<0.001,P=0.001,P<0.001,P<0.001).(3)In predicting the diagnostic value of severe snake bite,the areas under the curve of platelets and neutrophils were 0.944 and 0.638 respectively,and the best cut-off values were 64.5×109/L and 10.865×109/L respectively.The sensitivity was 86.5%,66.7%,and the specificity was 95.2%and 61.3%;The areas under the curve of NLR,PLR and SII were 0.656,0.873 and 0.780 respectively.The best cut-off values were 6.44,86.43 and 1289.08 respectively.The sensitivity was 95.2%,80.2%and 51.4%,and the specificity was 35.1%,90.5%and 95.2%.Conclusion:Platelet,PLR and SII in blood cell parameters are correlated with the severity of patients with snake bite,and platelet,PLR and SII may have more value in diagnosing severe snake bite.