Analysis of the clinical characteristics of myocardial injury caused by venomous snake bites
10.3760/cma.j.cn431274-20240614-00945
- VernacularTitle:毒蛇咬伤致心肌损伤的临床特征分析
- Author:
Jing CHEN
1
;
Mingrui LI
;
Yan DU
Author Information
1. 重庆市急救医疗中心超声科，重庆 400014
- Publication Type:Journal Article
- Keywords:
Snake bites;
Myocardial injury;
Electrocardiography
- From:
Journal of Chinese Physician
2025;27(4):547-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the related clinical characteristics of myocardial injury caused by venomous snake bites, and to provide a reference for cardiac protection and treatment in patients with venomous snake bites.Methods:A retrospective analysis was conducted on 294 patients with venomous snake bites admitted to Chongqing Emergency Medical Enter from January 2020 to December 2022. They were divided into the myocardial injury group ( n=90) and the non-myocardial injury group ( n=204) according to the presence or absence of abnormal electrocardiogram or/and cardiac troponin I (cTnI). The research subjects were divided into the mild group ( n=213), the moderate group ( n=57), and the severe group ( n=24) according to the severity of clinical manifestations. The time from bite to admission, laboratory indicators related to myocardial injury, electrocardiogram and echocardiogram of each group were analyzed and compared. Myocardial injury and electrocardiogram manifestations caused by bites from different types of venomous snakes were analyzed. Results:The abnormal electrocardiogram caused by venomous snake bites was mainly manifested as changes in the ST-T segment, and 84 patients showed abnormal electrocardiogram (28.6%). Compared with the non-myocardial injury group, patients in the myocardial injury group were older ( Z=-1.984, P=0.047), the time from bite to admission and the length of hospital stay were longer, and the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower (all P<0.05). The levels of cTnI, lactic acid dehydrogenase (LDH), creatine kinase (CK), creatine kinase MB (CK-MB), a-hydroxybutyrate dehydrogenase (a-HBDH), C-reactive protein (CRP), and the ratio of the peak of mitral valve velocity E to the peak of early diastolic velocity e at the annulus (E/e) in the myocardial injury group were higher than those in the non-myocardial injury group (all P<0.05). The left ventricular ejection fraction (LVEF) was lower than that in the non-myocardial injury group ( Z=-3.160, P=0.02). Compared with the mild group, the age of patients in the severe group was significantly older ( P=0.024), and the time from bite to admission was shown as mild group
