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OA

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.