汕头大学医学院学报2026，Vol.39Issue(2)：71-76,6.DOI:10.13401/j.cnki.jsumc.2026.02.002
竹叶青蛇咬伤后抗蛇毒血清注射延迟时间与输注强度的关联
Association between delay time of antivenom administration and infusion intensity after Trimeresurus stejnegeri bite
摘要
Abstract
Objective:To investigate the association between the delay time of antivenom administration and infusion intensity in patients bitten by Trimeresurus stejnegeri(TS)and to explore its non-linear characteristics.Methods:A retrospective cohort study was conducted,enrolling 275 patients with TS bites admitted to Huizhou First Hospital from July 2022 to June 2025.Infusion intensity was defined as 1 unit per dose of antivenom,with an additional 2 units when a combined regimen was administered.Spearman correlation analysis was used to evaluate the relationships between delay time and infusion intensity as well as admission coagulation indicators.Restricted cubic spline(RCS)analysis was performed to assess the non-linear relationship between delay time and infusion intensity,adjusting for age,kidney injury,platelet count,prothrombin time,and fibrinogen.Multivariable linear regression and sensitivity analyses were also conducted.Results:Spearman correlation analysis showed that delay time was positively correlated with infusion intensity(r=0.287,P<0.001);it was also positively correlated with prothrombin time(r=0.206)and international normalized ratio(r=0.226),and negatively correlated with activated partial thromboplastin time(r=-0.127)and fibrinogen(r=-0.179)(all P<0.05).RCS analysis revealed a significant overall association between delay time and infusion intensity(P=0.021),whereas the non-linearity test was not significant(P=0.085).In multivariable linear regression,delay time remained an independent factor associated with infusion intensity(β=0.013,95％CI:0.001-0.024,P=0.029).Sensitivity analysis showed that patients with a delay time>2 h had significantly higher infusion intensity(β=0.162,P=0.029).In logistic regression using≥2 infusions as the outcome,delay time was no longer significant(OR=1.040,P=0.215),whereas fibrinogen remained independently associated(OR=0.218,P<0.001).Conclusion:The delay time of antivenom administration after TS bite is independently associated with infusion intensity,exhibiting a linear trend overall.A delay time>2 h indicates higher infusion intensity,but in decisions regarding antivenom re-administration(≥2 infusions),fibrinogen level has greater predictive value than delay time.Emergency processes should be optimized to shorten the delay of antivenom administration,and dynamic monitoring of coagulation function(especially fibrinogen)should be strengthened.关键词
竹叶青蛇咬伤/抗蛇毒血清/延迟时间/输注强度/限制性立方样条/纤维蛋白原Key words
Trimeresurus stejnegeri bite/antivenom/delay time/infusion intensity/restricted cubic spline/fibrinogen分类
医药卫生引用本文复制引用
邱玉杏,张冬丹,李丹,罗顺琼,高裕城,唐银..竹叶青蛇咬伤后抗蛇毒血清注射延迟时间与输注强度的关联[J].汕头大学医学院学报,2026,39(2):71-76,6.基金项目
惠州市科技计划(2023CZ010081) （2023CZ010081）
