Early warning value of D-dimer and lactic acid on ulcer necrosis in patients bitten by cobra

LIU Yanling; ZHOU Wei; JIANG Weihan; CHEN Li

Abstract：Objective:To investigate the correlation and early warning value of D-dimer(D-D)and lactic acid(Lac)on ulcer necrosis caused by cobra bite.Methods:A total of 136 patients with cobra bite admitted to hospital from May 2021 to November 2022 were selected as the research objects.According to whether the limbs of the patients expe-rienced ulcer necrosis after cobra bite,the study cohort was divided into ulcer group(n=8 5)and non-ulcer group(n=51).The patients were followed up for 30 days after admission.Clinical data of all patients were collected,including demographic data,blood routine,D-D,and other blood biochemical test results.Clinical data,D-D and lactate levels were compared between the two groups.Multivariate Logistic regression was used to analyze the factors influencing the occurrence of ulcer caused by cobra bite,and receiver operating(ROC)curve was drawn to explore the predictive value of D-D and lactic acid levels on the occurrence of ulcer necrosis in cobra bite.Results:The levels of white blood cell count(WBC),neutrophil count(NEUT),neutrophil lymphocyte ratio(NLR),C-reactive protein(CRP),D-D in ul-cer group were significantly higher than those in non-ulcer group(P＜0.05).Logistic regression analysis showed that D-D,lactic acid were the factors affecting the occurrence of ulcer necrosis in cobra bite patients.Spearman correlation analysis showed that the severity score(SSS)of cobra bite patients was positively correlated with D-D,lactate level and neutrophil ratio(P＜0.05).ROC curve analysis showed that D-D and lactic acid had certain predictive value for ulcer necrosis in cobra bite patients(P＜0.05).Conclusion:D-D and lactic acid are associated with the risk of ulcer necrosis in patients with cobra bite and can be used as risk predictors of ulcer necrosis.Clinical care and treatment of co-bra bite patients with D-D and elevated blood lactic acid should be vigilant,strengthened monitoring,and individualized treatment strategies should be adopted to improve the poor prognosis.