肝素结合蛋白测定对肾结石患者全身炎症反应综合征的早期诊断价值  

Value of heparin-binding protein assay in the early diagnosis of systemic inflammatory response syndrome in patients with nephrolithiasis

作　　者：廖解志[1] 张宗新[2] 辛少军[2] 

机构地区：[1]湖州市中心医院泌尿外科,浙江湖州313000 [2]湖州市中心医院检验科,浙江湖州313000

出　　处：《中国卫生检验杂志》2017年第6期848-850,856,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨肝素结合蛋白对肾结石全身炎症反应综合征(SIRS)患者的早期诊断价值。方法收集2015年3月-2016年6月住院进行经皮肾镜取石术(PCNL)治疗患者67例,其中肾结石SIRS组41例,非SIRS组26例,检测非SIRS组及SIRS组治疗前、治疗后6 h、治疗后24 h的肝素结合蛋白(HBP)、降钙素原(PCT)、C-反应蛋白(CRP)水平。比较各组之间上述3种指标的变化,评价HBP对肾结石SIRS的诊断价值。结果肾结石SIRS组HBP、PCT、CRP水平均高于非SIRS组,差异有统计学意义(P<0.01);PCNL治疗24 h后SIRS组肝素结合蛋白水平与治疗6 h后比较差异无统计学意义(P>0.05)。受试者工作曲线(ROC)分析显示,HBP对肾结石SIRS诊断界值为2.61 ng/ml,曲线下面积是0.842,灵敏度和特异度分别为74.5%和88.2%,均显著高于PCT(72.5%、85.1%)及CRP(70.4%、74.8%)。结论HBP可作为肾结石全身炎症反应综合征早期诊断的指标,并能作为监视肾结石SIRS风险的生物标志物。Objective To investigate the diagnostic value of heparin-binding protein level in patients with systemic inflammatory response syndrome（ SIRS） and nephrolithiasis. Methods 67 nephrolithiasis patients in hospital were prospectively collected from March 2015 to Jun 2016. 41 patients of nephrolithiasis were diagnosed as SIRS group and 26 patients were diagnosed as non-SIRS group. Heparin-binding protein（ HBP）,procalcitonin（ PCT） and C-reactive protein（ CRP） levels were measured before treatment,6 hours after treatment and 24 hours after treatment between Non-SIRS group and SIRS group. The changes of the above three indexes between the groups were compared to determine the diagnostic value of these variables in patients with SIRS and nephrolithiasis. Results The levels of HBP,PCT and CRP in SIRS group were significantly higher than those in non-SIRS group,with the differences statistically significant（ P〈0. 01）. There was no statistical significance on the difference of HBP levels between 6 hours after treatment and 24 hours after treatment（ P〉0. 05）. ROC analysis showed that the cut-off value of SIRS was 2. 61 ng/ml. The area under curve（ AUC） of HBP was 0. 842. Therefore,HBP displayed a higher sensitivity（ 74. 5%） and specificity（ 88. 2%） than PCT（ 72. 5% and 85. 1%） and CRP（ 70. 4% and 74. 8%）. Conclusion HBP can be used as an indicator for the early diagnosis of SIRS in patients with nephrolithiasis and as a biomarker for monitoring the risk of SIRS in nephrolithiasis.

关 键 词：肾结石 全身炎症反应综合征 肝素结合蛋白 降钙素原 C-反应蛋白 

分 类 号：R699.2[医药卫生—泌尿科学]