胡蜂蛰伤致急性肾损伤治疗新进展
|
摘要
胡蜂蛰伤是我国导致急性肾损伤(acute kidney injury,AKI)的重要原因之一,但目前相关的临床研究较少。胡蜂毒素成分复杂,主要包括酶类、生物胺类、肽类及其他成分。胡蜂蜇伤可导致过敏反应及全身毒性反应如AKI等。胡蜂蛰伤致AKI主要为继发于血管内溶血和/或横纹肌溶解,也可通过蜂毒的直接肾毒性导致。胡蜂蛰伤致AKI患者行肾穿刺活检表明大部分患者肾脏病理改变表现为急性肾小管坏死,部分患者表现为急性间质性肾炎。不同的肾脏替代治疗方式被用于治疗胡蜂蛰伤致AKI,推荐在血流动力学不稳定时优先选择持续肾脏替代治疗。结合研究组新近研究进展,就近年来蜂蛰伤致AKI治疗(特别是肾脏替代治疗)及预后评估方面的新进展做一总结。
Wasp sting is one of the important causes of acute kidney injury( AKI) in China,but there are few related clinical studies. The constituents of wasp venom are complex,mainly including enzymes,biogenic amines,peptides and other components.Wasp sings can induce allergic reactions and systemic toxic reactions such as AKI. AKI induced by wasp stings is usually mediated by a combination of intravascular hemolysis and/or rhabdomyolysis,and can also be caused by direct nephrotoxic effects of the bee venom.Renal biopsy of patients with AKI caused by wasp stings has demonstrated that most patients have pathological changes of acute tubular necrosis,and some develop acute interstitial nephritis. Different renal replacement therapies have been used to treat severe AKI induced by wasp stings. Continuous renal replacement therapy is recommended in patients with hemodialysis instability. In this review,we aim to integrate results reported in recent years by ourselves and others to summarize the new progress in the treatment and prognosis of AKI.
Wasp sting is one of the important causes of acute kidney injury( AKI) in China,but there are few related clinical studies. The constituents of wasp venom are complex,mainly including enzymes,biogenic amines,peptides and other components.Wasp sings can induce allergic reactions and systemic toxic reactions such as AKI. AKI induced by wasp stings is usually mediated by a combination of intravascular hemolysis and/or rhabdomyolysis,and can also be caused by direct nephrotoxic effects of the bee venom.Renal biopsy of patients with AKI caused by wasp stings has demonstrated that most patients have pathological changes of acute tubular necrosis,and some develop acute interstitial nephritis. Different renal replacement therapies have been used to treat severe AKI induced by wasp stings. Continuous renal replacement therapy is recommended in patients with hemodialysis instability. In this review,we aim to integrate results reported in recent years by ourselves and others to summarize the new progress in the treatment and prognosis of AKI.
引文
[1] SILVA G B D J,VASCONCELOS A G J,ROCHA A M T,et al.Acute kidney injury complicating bee stings-a review[J]. Revista do Instituto de Medicina Tropical de Sao Paulo,2017(59):25.
[2] YANG L. Acute Kidney Injury in Asia[J]. Kidney diseases,2016(2):95-102.
[3]中华人民共和国国家卫生健康委员会,胡蜂蜇伤诊疗原则[J].中国实用乡村医生杂志,2013(20):3-4.
[4] SITPRIJA V, BOONPUCKNAVIG V. Renal failure and myonecrosis following wasp-stings[J]. Lancet,1972(1):749-750.
[5] XIE C,XU S,DING F,et al. Clinical features of severe wasp sting patients with dominantly toxic reaction:analysis of 1091 cases[J]. Plo S one,2013(8):83164.
[6] VACHVANICHSANONG P,DISSANEEWATE P,MITARNUN W. Non-fatal acute renal failure due to wasp stings in children[J]. Pediatric nephrology,1997(11):734-736.
[7] VACHVANICHSANONG P,DISSANEEWATE P. Acute renal failure following wasp sting in children[J]. European journal of pediatrics,2009(168):991-994.
[8] LIU L,ZHANG L,LIU G J,et al. Peritoneal dialysis for acute kidney injury[J]. The Cochrane database of systematic reviews,2017(12):11457.
[9] CASALE T B,BURKS A W. Clinical practice. Hymenopterasting hypersensitivity[J]. The New England journal of medicine,2014(370):1432-1439.
[10] YUAN H,CHEN S,HU F,et al. Efficacy of two combinations of blood purification techniques for the treatment of multiple organ failure induced by wasp stings[J]. Blood purification,2016(42):49-55.
[11] HABERMANN E. Bee and wasp venoms[J]. Science,1972(177):314-322.
[12] DONGOL Y,SHRESTHA R,ARYAL G,et al. Hymenoptera stings and the acute kidney injury[J]. European Medical JournalNephrology,2013(1):68-75.
[13] VIKRANT S,PARASHAR A. Wasp venom-induced acute kidney injury:a serious health hazard[J]. Kidney international,2017(92):1288.
[14] SHARMILA R R,CHETAN G,NARAYANAN P,et al. Multiple organ dysfunction syndrome following single wasp sting[J].Indian journal of pediatrics,2007(74):1111-1112.
[15] KUMAR V,NADA R,KUMAR S,et al. Acute kidney injury due to acute cortical necrosis following a single wasp sting[J]. Renal failure,2013(35):170-172.
[16] MORENO M,GIRALT E. Three valuable peptides from bee and wasp venoms for therapeutic and biotechnological use:melittin,apamin and mastoparan[J]. Toxins,2015(7):1126-1150.
[17] RADHAKRISHNAN H. Acute kidney injury and rhabdomyolysis due to multiple wasp stings, Indian journal of critical care medicine:peer-reviewed[J]. Official Publication of Indian Society of Critical Care Medicine,2014(18):470-472.
[18] VIKRANT S,PARASHAR A. Two cases of acute kidney injury due to multiple wasp stings[J]. Wilderness&environmental medicine,2017(28):249-252.
[19] RUNGSA P,PEIGNEUR S,DADUANG S,et al. Purification and biochemical characterization of Ves T1s,a novel phospholipase A1isoform isolated from the venom of the greater banded wasp Vespa tropica[J]. Toxicon:official journal of the International Society on Toxinology,2018(148):74-84.
[20] KONNO K,KAZUMA K,NIHEI K. Peptide toxins in solitary wasp venoms[J]. Toxins,2016(8):114.
[21] ZAGER R A. Rhabdomyolysis and myohemoglobinuric acute renal failure[J]. Kidney international,1996(49):314-326.
[22] ZHANG L,YANG Y,TANG Y, et al. Recovery from AKI following multiple wasp stings:a case series[J]. Clinical journal of the American Society of Nephrology:CJASN,2013(8):1850-1856.
[23] DHANAPRIYA J,DINESHKUMAR T,SAKTHIRAJAN R,et al. Wasp sting-induced acute kidney injury[J]. Clinical kidney journal,2016(9):201-204.
[24] PRZYBILLA B,RUEFF F. Insect stings:clinical features and management[J]. Deutsches Arzteblatt international,2012(109):238-248.
[25] VIKRANT S,PANDEY D,MACHHAN P, et al. Wasp envenomation-induced acute renal failure:a report of three cases[J]. Nephrology,2005(10):548-552.
[26] ZHANG L, LI Z, FU P,et al. Hybrid renal replacement treatment in acute pulmonary edema with acute kidney injury following multiple wasp stings:a report of 3 cases[J]. Blood Purification,2010(30):106-107.
[27] HEUNG M,YESSAYAN L. Renal replacement therapy in acute kidney injury:controversies and consensus[J]. Critical care clinics,2017(33):365-378.
[28] SI X,LI J,BI X,et al. Clinical evaluation of high-volume hemofiltration with hemoperfusion followed by intermittent hemodialysis in the treatment of acute wasp stings complicated by multiple organ dysfunction syndrome[J]. Plo S one,2015(10):132708.
[29] VIKRANT S,PARASHAR A. Acute kidney injury due to multiple Hymenoptera stings-a clinicopathological study[J]. Clinical kidney journal,2017(10):532-538.
[30] SIGDEL M R,RAUT K B. Wasp bite in a referral hospital in Nepal[J]. Journal of Nepal Health Research Council,2013(11):244-250.
[31]谷晓玲,甘林望,吴蔚桦,等.蜂蜇伤致急性肾损伤的危险因素分析[J].中华危重病急救医学,2015(10):386-388.
[32]李甫罡,刘利,张勇,等.蜂蛰伤后临床特点及发生急性肾损伤的危险因素分析[J].临床肾脏病杂志,2017(10):663-666.
[33]秦永芳,袁海,徐廷伟.蜂蜇伤患者尿肾损伤分子1变化及其与肾损害的关系[J].中国医师杂志,2013(22):713-714.
[34]朱平,谢莉,杨林.蜂蛰伤致急性肾损伤患者高迁移率族蛋白B1的水平及意义[J].广东医学,2014(15):3007-3009.
[35]朱平,谢莉,杨林. IL-33测定及其与蜂蛰伤致急性肾损伤关系的研究[J].海南医学,2014(16):526-528.
[36] ZHANG R, MELEG-SMITH S, BATUMAN V. Acute tubulointerstitial nephritis after wasp stings[J]. American journal of kidney diseases:the official journal of the National Kidney Foundation,2001(38):33.
[37] NADDI M,SARKAR S. Acute kidney injury following multiple wasp stings[J]. Pediatric nephrology,2012(27):2315-2317.
[38] NATARAJAN G,JEYACHANDRAN D,THANIGACHALAM D,et al. Kurien AA,myoglobinuric renal failure after a wasp attack[J]. Kidney international,2016(89):725.
[2] YANG L. Acute Kidney Injury in Asia[J]. Kidney diseases,2016(2):95-102.
[3]中华人民共和国国家卫生健康委员会,胡蜂蜇伤诊疗原则[J].中国实用乡村医生杂志,2013(20):3-4.
[4] SITPRIJA V, BOONPUCKNAVIG V. Renal failure and myonecrosis following wasp-stings[J]. Lancet,1972(1):749-750.
[5] XIE C,XU S,DING F,et al. Clinical features of severe wasp sting patients with dominantly toxic reaction:analysis of 1091 cases[J]. Plo S one,2013(8):83164.
[6] VACHVANICHSANONG P,DISSANEEWATE P,MITARNUN W. Non-fatal acute renal failure due to wasp stings in children[J]. Pediatric nephrology,1997(11):734-736.
[7] VACHVANICHSANONG P,DISSANEEWATE P. Acute renal failure following wasp sting in children[J]. European journal of pediatrics,2009(168):991-994.
[8] LIU L,ZHANG L,LIU G J,et al. Peritoneal dialysis for acute kidney injury[J]. The Cochrane database of systematic reviews,2017(12):11457.
[9] CASALE T B,BURKS A W. Clinical practice. Hymenopterasting hypersensitivity[J]. The New England journal of medicine,2014(370):1432-1439.
[10] YUAN H,CHEN S,HU F,et al. Efficacy of two combinations of blood purification techniques for the treatment of multiple organ failure induced by wasp stings[J]. Blood purification,2016(42):49-55.
[11] HABERMANN E. Bee and wasp venoms[J]. Science,1972(177):314-322.
[12] DONGOL Y,SHRESTHA R,ARYAL G,et al. Hymenoptera stings and the acute kidney injury[J]. European Medical JournalNephrology,2013(1):68-75.
[13] VIKRANT S,PARASHAR A. Wasp venom-induced acute kidney injury:a serious health hazard[J]. Kidney international,2017(92):1288.
[14] SHARMILA R R,CHETAN G,NARAYANAN P,et al. Multiple organ dysfunction syndrome following single wasp sting[J].Indian journal of pediatrics,2007(74):1111-1112.
[15] KUMAR V,NADA R,KUMAR S,et al. Acute kidney injury due to acute cortical necrosis following a single wasp sting[J]. Renal failure,2013(35):170-172.
[16] MORENO M,GIRALT E. Three valuable peptides from bee and wasp venoms for therapeutic and biotechnological use:melittin,apamin and mastoparan[J]. Toxins,2015(7):1126-1150.
[17] RADHAKRISHNAN H. Acute kidney injury and rhabdomyolysis due to multiple wasp stings, Indian journal of critical care medicine:peer-reviewed[J]. Official Publication of Indian Society of Critical Care Medicine,2014(18):470-472.
[18] VIKRANT S,PARASHAR A. Two cases of acute kidney injury due to multiple wasp stings[J]. Wilderness&environmental medicine,2017(28):249-252.
[19] RUNGSA P,PEIGNEUR S,DADUANG S,et al. Purification and biochemical characterization of Ves T1s,a novel phospholipase A1isoform isolated from the venom of the greater banded wasp Vespa tropica[J]. Toxicon:official journal of the International Society on Toxinology,2018(148):74-84.
[20] KONNO K,KAZUMA K,NIHEI K. Peptide toxins in solitary wasp venoms[J]. Toxins,2016(8):114.
[21] ZAGER R A. Rhabdomyolysis and myohemoglobinuric acute renal failure[J]. Kidney international,1996(49):314-326.
[22] ZHANG L,YANG Y,TANG Y, et al. Recovery from AKI following multiple wasp stings:a case series[J]. Clinical journal of the American Society of Nephrology:CJASN,2013(8):1850-1856.
[23] DHANAPRIYA J,DINESHKUMAR T,SAKTHIRAJAN R,et al. Wasp sting-induced acute kidney injury[J]. Clinical kidney journal,2016(9):201-204.
[24] PRZYBILLA B,RUEFF F. Insect stings:clinical features and management[J]. Deutsches Arzteblatt international,2012(109):238-248.
[25] VIKRANT S,PANDEY D,MACHHAN P, et al. Wasp envenomation-induced acute renal failure:a report of three cases[J]. Nephrology,2005(10):548-552.
[26] ZHANG L, LI Z, FU P,et al. Hybrid renal replacement treatment in acute pulmonary edema with acute kidney injury following multiple wasp stings:a report of 3 cases[J]. Blood Purification,2010(30):106-107.
[27] HEUNG M,YESSAYAN L. Renal replacement therapy in acute kidney injury:controversies and consensus[J]. Critical care clinics,2017(33):365-378.
[28] SI X,LI J,BI X,et al. Clinical evaluation of high-volume hemofiltration with hemoperfusion followed by intermittent hemodialysis in the treatment of acute wasp stings complicated by multiple organ dysfunction syndrome[J]. Plo S one,2015(10):132708.
[29] VIKRANT S,PARASHAR A. Acute kidney injury due to multiple Hymenoptera stings-a clinicopathological study[J]. Clinical kidney journal,2017(10):532-538.
[30] SIGDEL M R,RAUT K B. Wasp bite in a referral hospital in Nepal[J]. Journal of Nepal Health Research Council,2013(11):244-250.
[31]谷晓玲,甘林望,吴蔚桦,等.蜂蜇伤致急性肾损伤的危险因素分析[J].中华危重病急救医学,2015(10):386-388.
[32]李甫罡,刘利,张勇,等.蜂蛰伤后临床特点及发生急性肾损伤的危险因素分析[J].临床肾脏病杂志,2017(10):663-666.
[33]秦永芳,袁海,徐廷伟.蜂蜇伤患者尿肾损伤分子1变化及其与肾损害的关系[J].中国医师杂志,2013(22):713-714.
[34]朱平,谢莉,杨林.蜂蛰伤致急性肾损伤患者高迁移率族蛋白B1的水平及意义[J].广东医学,2014(15):3007-3009.
[35]朱平,谢莉,杨林. IL-33测定及其与蜂蛰伤致急性肾损伤关系的研究[J].海南医学,2014(16):526-528.
[36] ZHANG R, MELEG-SMITH S, BATUMAN V. Acute tubulointerstitial nephritis after wasp stings[J]. American journal of kidney diseases:the official journal of the National Kidney Foundation,2001(38):33.
[37] NADDI M,SARKAR S. Acute kidney injury following multiple wasp stings[J]. Pediatric nephrology,2012(27):2315-2317.
[38] NATARAJAN G,JEYACHANDRAN D,THANIGACHALAM D,et al. Kurien AA,myoglobinuric renal failure after a wasp attack[J]. Kidney international,2016(89):725.