多指标检测对于复杂性上尿路感染导致尿脓毒血症的价值分析  

Value of detection of multiple indicators in urinary sepsis induced by complicated upper urinary tract infections

作　　者：杨立新[1] 马凤巧[2] 胡跃世[1] 朱清[1] 孙文琪[1] 曹志华[1] 

机构地区：[1]郑州大学附属南阳市中心医院泌尿外科,河南南阳473000 [2]南阳医学高等专科学校医教室,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第2期284-287,共4页Chinese Journal of Nosocomiology

基　　金：河南省卫生计生委科技攻关项目(201405011)

摘　　要：目的探讨降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)及白细胞计数(WBC)多指标检测对于复杂性上尿路感染导致尿脓毒血症的价值,以期为尿脓毒血症寻找早期鉴别诊断指标。方法选取2013年1月-2016年1月医院泌尿外科收治复杂性上尿路感染患者且术后并发尿脓毒血症患者84例为观察组,另选同期住院术后发生尿路感染患者60例为对照1组,同期住院脓毒血症患者60例为对照2组;观察组与对照2组确诊后抽血送检,对照1组确诊尿路感染后抽血送检;观察3组患者PCT、CRP、IL-6及WBC水平,根据脓毒血症严重程度及治疗结局将观察组及对照2组进行划分,观察不同严重程度及治疗结局患者观察指标水平变化。结果观察组各项观察指标均高于对照1组(P<0.05),CRP、IL-6及WBC指标低于对照2组(P<0.05),观察组与对照2组严重患者各项指标均高于同组非严重患者(P<0.05),观察组不同程度患者CRP、IL-6及WBC指标水平均低于对照2组同程度(P<0.05),观察组与对照2组死亡患者各项指标均高于同组存活患者(P<0.05),观察组不同治疗结局患者CRP、IL-6及WBC指标水平低于对照2组同结局患者(P<0.05);尿脓毒血症各项指标均呈正相关(P<0.05),灵敏度及特异性依次为PCT、CRP、IL-6、WBC。结论 PCT、CRP、IL-6及WBC水平与尿脓毒血症病情均具有相关性,随病情程度增加而增高,PCT对疾病早期诊断具有重要意义,但对鉴别病源部位效果欠佳,联合检验PCT、CRP对复杂性上尿路感染导致的脓毒血症意义重大。OBJECTIVE To explore the value of detection of multiple indicators procalcitonin （PCT）, C-reactive protein （CRP）, interleukin-6 （IL-6）, and white blood cell （WBC） counts in urinary sepsis induced by complicated upper urinary tract infections so as to seek the appropriate indicators for early differential diagnosis of urinary sepsis. METHODS A total of 84 complicated upper urinary tract infection patients complicated with postoperative urinary sepsis who were treated in the urology department from Jan 2013 to Jan 2016 were chosen as the observation group, meanwhile, 60 patients who were hospitalized and had postoperative urinary tract infections were set as the control group 1, and 60 patients who were hospitalized and had sepsis were chosen as the control group 2. The blood specimens of the patients in the observation group the diagnosis, and the blood specimens of the patients in and the control group 2 were drawn and submitted after the control group 1 were drawn and submitted after they were diagnosed with urinary tract infections. The levels of PCT, CRP, IL-6, and WBC were observed and compared among the three groups of patients, the patients in the observation group and the control group 2 were classified according to the severity of sepsis and treatment outcomes, and the levels of the indicators were observed and compared among the patients with different severities of sepsis and treatment outcomes. RESULTS The levels of the indicators were higher in the observation group than in the control group 1 （P〈0.05）; the levels of CRP, IL-6, and WBC of the observation group were lower than those of the control group 2. In the observation group and the control group 2, the levels of the indicators of the patients with severe sepsis were higher than those of the patients with non-severe sepsis （P〈0.05） ; the levels of CRP, IL-6, and WBC of the patients with different severities of sepsis in the observation group were lower than those of the patients in the control group 2. In the observati

关 键 词：降钙素原 C-反应蛋白 白细胞介素-6 白细胞计数 复杂性上尿路感染 尿脓毒血症 

分 类 号：R631.2[医药卫生—外科学]