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目的:探讨肌酸激酶同工酶（CK-MB）与中毒严重程度评分（PSS）对胡蜂蜇伤患者预后的预测价值。方法:采用回顾性研究方法，收集2017年7月至2019年11月河南科技大学第一附属医院急诊医学部收治的资料完整的胡蜂蜇伤患者的临床资料。收集患者入院24 h内急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）、CK-MB及PSS评分，并记录28 d转归。采用Spearman相关分析法分析CK-MB与PSS评分的相关性；采用Logistic回归模型构建联合预测因子，并绘制受试者工作特征曲线（ROC曲线），评估各项指标对胡蜂蜇伤患者28 d预后的预测价值。结果:最终90例患者纳入分析，28 d存活67例，死亡23例，28 d病死率为25.6%。死亡组患者APACHEⅡ评分、CK-MB及PSS评分均明显高于存活组〔APACHEⅡ评分（分）：19.7±2.7比13.7±2.3，CK-MB（U/L）：183（151，243）比36（21，75），PSS评分（分）：17.7±2.6比9.3±4.5，均n P<0.01〕。相关分析显示，CK-MB与PSS评分呈显著正相关（n r＝0.843，n P<0.01）。Logistic回归模型拟合CK-MB与PSS评分，Hosmer-Lemeshow拟合度检验提示模型拟合良好。ROC曲线分析显示，CK-MB预测胡蜂蜇伤患者28 d预后的ROC曲线下面积（AUC）为0.957，敏感度为91.3%，特异度为88.1%；PSS评分的AUC为0.908，敏感度为91.3%，特异度为90.8%；CK-MB联合PSS评分的AUC为0.964，敏感度为100%，特异度为79.4%，说明CK-MB联合PSS评分对胡蜂蜇伤患者28 d预后的预测价值更大，敏感度也更高。n 结论:胡蜂蜇伤患者早期高CK-MB水平及高PSS评分提示预后不佳。CK-MB及PSS评分均可作为胡蜂蜇伤患者预后的预测因子，以CK-MB联合PSS评分的预测价值更大。“,”Objective:To explore the predictive value of MB isoenzyme of creatine kinase (CK-MB) and poisoning severity score (PSS) in the clinical prognosis of patients with wasp sting.Methods:A retrospective study was conducted. The clinical data of patients who were stung by wasps admitted to emergency department of the First Affiliated Hospital of Henan University of Science and Technology from July 2017 to November 2019 were collected. The 24-hour acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), CK-MB and PSS scores of the patients were collected after admission, and 28-day outcome was recorded. Spearman correlation analysis method was used to analyze the correlation between CK-MB and PSS score. Logistic regression model was used to construct joint predictors, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of various indicators for 28-day prognosis of patients with wasp stings.Results:Finally 90 patients were included in the analysis. There were 67 patients survived at 28 days, and 23 dead with the 28-day mortality of 25.6%. APACHEⅡ score, CK-MB and PSS score in the death group were significantly higher than those in the survival group [APACHEⅡscore: 19.7±2.7 vs. 13.7±2.3, CK-MB (U/L): 183 (151, 243) vs. 36 (21, 75), PSS score: 17.7±2.6 vs. 9.3±4.5, all n P < 0.01]. The correlation analysis showed that CK-MB and PSS score were positively correlated ( n r = 0.843, n P < 0.01). Logistic regression model fitted CK-MB and PSS score, and Hosmer-Lemeshow test showed that the model fitted well. ROC curve analysis showed that the area under ROC curve (AUC) of CK-MB for predicting 28-day outcome was 0.957, the sensitivity was 91.3%, and the specificity was 88.1%; the AUC of PSS score was 0.908, the sensitivity was 91.3%, and the specificity was 90.8%. The AUC of CK-MB combined with PSS score was 0.964, the sensitivity was 100%, and the specificity was 79.4%, indicating that CK-MB combined with PSS score had higher predictive value and higher sensitivity for 28-day prognosis of patients with wasp sting.n Conclusions:High CK-MB level and high PSS score in early stage of wasp sting injury indicate poor prognosis. Both CK-MB and PSS score can be used as predictors for predicting the prognosis of patients with wasp stings. In addition, CK-MB combined with PSS score have greater predictive value .