Value Of Dynamic Changes Of Myocardial Enzymes And Liver Function After Snake Bite In Prognosis Evaluation

Objective This study retrospectively analyzed 225 cases of agkistrodon bite patients admitted to the emergency department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The clinical data of agkistrodon bite patients during hospitalization were sorted out and statistically analyzed.The myocardial enzymes and liver function indexes of agkistrodon bite patients were dynamically observed.The factors affecting the prognosis of patients at each time cut-off point were obtained,and then the analysis and comparison were made to facilitate the disease and liver function.Early intervention and prevention to guide clinical treatment.Methods The clinical data of 225 patients bitten by Agkistrodon bite from March 2013 to November 2017 in the Emergency Department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were retrospectively analyzed.Firstly,general data such as patient’s name,sex,age,location of bite,occupational distribution,time from bite to admission,days of hospitalization,total cost of hospitalization,and whether or not to take traditional Chinese medicine orally were collected.According to the laboratory indicators of blood sampling,the main indicators collected and observed dynamically were White blood cell(WBC)、 High-sensitivity C-reactive protein(HS-CRP)、Creatine kinase(CK)、Creatine kinase isoenzyme(CK-MB)、Lactate dehydrogenase(LDH)、 Alanine aminotransferase(ALT)、 Aspartate aminotransferase(AST)、 Total bilirubin(TBIL)、 Urea nitrogen(UREA)、 Serum creatinine(SCR)、Prothrombin time(PT)、Activated partial thromboplastin time(APTT)of which three indicators of myocardial enzymes are CK,CK-MB,LDH,and three indicators of liver function are ALT,AST,TBIL.The three times of inspection and observation were within 24 hours after admission,the third day of hospitalization and the fifth day of hospitalization.According to the clinical manifestations of patients bitten on the 5th day of hospitalization and the detection indexes of WBC,HS-CRP,CK,CK-MB,LDH,ALT,AST,TBIL,UREA,SCR,PT and APTT,the patients were divided into recovery group and improvement group.Using SPSS 21.0 software,normal test and variance analysis were carried out on general data and myocardial enzymes and liver function indexes of two groups of patients within 24 hours after admission,3 days after admission and 5 days after admission.Two independent sample t-test was used for normal distribution and variance homogeneity measurement data,and Mann-whitney U-test was used for non-normal distribution and variance homogeneity measurement data.The data were expressed by mean(+standard deviation).Chi-square test was used for counting data.The significant level was P < 0.05.Results 1.The hospitalization days and total expenditure of the improved group were higher than those of the cured group,with significant differences in hospitalization days(z = 7.427,P < 0.01)and total hospitalization expenses(z = 6.794,P < 0.01).2.After admission,the patients were given snakebite granule orally,which accounted for 33.33% of the patients recovered by oral Chinese medicine and 12% of the patients were cured without oral administration of traditional Chinese medicine.x2 = 11.762,P < 0.01,the difference was significant.3.Within 24 hours after admission,there were significant differences in CK(z = 5.795,P < 0.01),CK-MB(z = 4.280,P < 0.01),LDH(z = 3.287,P = 0.001),ALT(z = 4.429,P < 0.01),AST(z = 4.354,P < 0.01)and TBIL(z = 2.265,P = 0.024)between the two groups.4.On the third day of hospitalization,there were no significant differences in CK(z=1.849,p=0.064),CK-MB(z=1.270,p=0.204),LDH(z=1.587,p=0.113),ALT(z=1.707,p=0.088),AST(z=1.761,p=0.078),TBIL(z=0.894,p=0.372)between the two groups.More than 0.05;5.On the fifth day of hospitalization,there were significant differences in CK(z = 5.222,P < 0.01),LDH(z = 5.084,P < 0.01),ALT(z = 3.744,P < 0.01),AST(z = 5.019,P < 0.01),TBIL(z = 2.641,P = 0.008)between the two groups.there was no significant difference in CK-MB(z = 0.971,p=0.331).Conclusion 1)hospitalization total expenses and the hospitalization days of the recovered group were less than those of the improved group(but the improved group was eventually cured and discharged).2)The clinical symptoms of the patients can be significantly improved after oral snakebite granule(hospital agreement).3)It is suggested to observe and monitor CK,CK-MB,LDH,ALT,AST,TBIL and CK,LDH,ALT,AST,TBIL on the 5th day after admission,but not on the 3rd day after admission,so as to effectively evaluate the prognosis of patients and reduce the cost of hospitalization.