血清PCT、CRP、LPS预测肾盂及输尿管结石患者术后泌尿系统感染的应用价值及风险因素分析  

Application value and risk factors analysis of serum PCT,CRP and LPS in predicting postoperative urinary tract infection in patients with renal pelvis and ureteral calculi

作　　者：曹彬[1] 黄红星[1] 黄亚强[1] 罗刚[1] 卢扬柏[1] 连文清 陈帅 李灿永 王强 CAO Bin;HUANG Hongxing;HUANG Yaqiang;LUO Gang;LU Yangbo;LIAN Wenqing;CHEN Shuai;LI Canyong;WANG Qiang(Department of Urology,Zhongshan City People's Hospital,Zhongshan,Guangdong,528403,China)

机构地区：[1]中山市人民医院泌尿外科一区,广东中山528403

出　　处：《临床泌尿外科杂志》2020年第6期435-438,共4页Journal of Clinical Urology

摘　　要：目的:分析血清降钙素原(Procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、脂肪酶(Lipase,LPS)在预测肾盂及输尿管结石患者术后泌尿系统感染的应用价值以及风险因素。方法:回顾性分析2017年1月~2019年6月于我院行手术治疗的654例肾盂及输尿管结石患者临床资料,依据术后是否发生泌尿系统感染分为未感染组619例以及发生泌尿系统感染的感染组35例,对两组血清PCT、CRP、LPS检测结果进行对比,分析以上指标的预测价值,利用Logistic回归分析法总结诱发肾盂及输尿管结石患者术后泌尿系统感染的独立风险因素。结果:两组血清PCT、CRP、LPS比较差异有统计学意义(P<0.05);三指标联合灵敏度、特异度最高,单指标单独检测最低,两两联合介于其中,差异有统计学意义(P<0.05),单指标间以及两两指标间差异无统计学意义(P>0.05);Logistic回归分析结果提示,年龄>60岁、合并糖尿病、免疫功能低、尿管留置时间>7 d为肾盂及输尿管结石患者术后泌尿系统感染的独立风险因素(OR:6.521、6.903、7.538、10.288,P<0.05)。结论:肾盂及输尿管结石术后泌尿系统感染的风险因素众多,通过检测血清PCT、CRP、LPS有助于预测泌尿系统感染的发生,联合检测预测效能更高。Objective: To analyze the clinical value of serum procalcitonin(PCT), C-reactive protein(CRP) and lipase(LPS) in predicting postoperative urinary tract infection in patients with renal pelvis and ureteral calculi and risk factors. Method: The clinical data of 654 patients with renal pelvis and ureteral calculi who underwent surgery in our hospital from January 2017 to June 2019 were retrospectively analyzed. According to whether urinary tract infection occurred after operation, patients were divided into uninfected group(619 cases) and infected group(35 cases). Results of PCT, CRP and LPS were compared between two groups. The predictive value of the above indicators was analyzed. Logistic regression analysis was used to summarize the independent risk factors of postoperative urinary tract infection in patients with renal pelvis and ureteral calculi. Result: There was significant difference in serum PCT, CRP and LPS between the two groups(P<0.05). The combined sensitivity and specificity of the three indicators were the highest, but those of the single index were the lowest. The difference between the two groups was statistically significant(P<0.05), but there was no statistical difference between single indicator or between the two indicators(P>0.05). Logistic regression analysis showed that age>60 years old, combined with diabetes, low immune function, urinary catheter indwelling time>7 d were independent risk factors for postoperative urinary tract infection in patients with calculi(OR: 6.521, 6.903, 7.538, 10.288, P<0.05). Conclusion: There are many risk factors of urinary tract infection in patients with renal pelvis and ureteral calculi after operation. However, the detection of serum PCT, CRP and LPS can help to predict the occurrence of urinary tract infection.

关 键 词：肾盂及输尿管结石 泌尿系统感染 降钙素原 C反应蛋白 脂肪酶 

分 类 号：R699[医药卫生—泌尿科学]