C-反应蛋白在上尿路结石梗阻性脓肾中的表达及其危险因素分析  

Expression of C-reactive protein in obstructive pyonephrosis with upper urinary calculi and its risk factors

作　　者：覃天资 黄群[1] 黄敏玉[1] 吴军[1] QIN Tianzi;HUANG Qun;HUANG Minyu;WU Jun(Department of Urology,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise,Guangxi,533000,China)

机构地区：[1]右江民族医学院附属医院泌尿外科,广西百色533000

出　　处：《临床泌尿外科杂志》2020年第8期651-654,657,共5页Journal of Clinical Urology

基　　金：2020年度广西高校中青年教师科研基础能力提升项目(No:2020KY13014)。

摘　　要：目的:探讨C-反应蛋白(C-reactive protein,CRP)水平在上尿路结石梗阻性肾病中的变化及其危险因素分析。方法:选取2016年1月~2017年12月我院收治的上尿路结石梗阻性肾病病例,按其是否进展为脓肾分成脓肾组及非脓肾组,收集各组一般临床资料及各项实验室指标,分别对各组患者年龄、性别、BMI、血清CRP、外周血白细胞计数(WBC)、尿WBC、肌酐(CR)、血清白蛋白(ALB)、谷丙转氨酶(ALT)、尿酸(UA)、空腹血糖(FPG)、肾积水程度、尿培养、血清钾(K^+)等影响因素进行单因素分析,并对显著相关性影响因素进行二元Logistic回归分析。绘制ROC曲线评价各危险因素预测上尿路结石梗阻进展为脓肾的价值。结果:单因素分析提示脓肾组血WBC、尿WBC、CRP水平及尿培养阳性率均明显高于非脓肾组,BMI及ALB水平明显低于非脓肾组,两组比较差异有统计学意义(P<0.01)。二元Logistic回归分析显示,低BMI、低ALB、CRP是上尿路结石梗阻进展为脓肾的独立危险因素,其OR及95%CI分别为0.509(0.310~0.836)、0.691(0.522~0.915)、1.189(1.016~1.391),外周血、尿WBC与上尿路结石梗阻性脓肾进展无明显相关(P>0.05)。ROC曲线分析显示,BMI、ALB、CRP的AUC分别为0.655、0.901、0.888,ALB及CRP对预测上尿路梗阻进展为脓肾有更高的效能,当CRP的最佳阈值取11.94 mg/L时,其敏感性和特异性较好,分别为88.89%和86.79%。结论:血清CRP水平在上尿路结石梗阻性脓肾患者中明显升高,可作为预测上尿路结石梗阻进展为脓肾的独立危险因素。Objective:To investigate the changes of C-reactive protein(CRP)level in upper urinary tract stone obstructive nephropathy and its risk factors.Method:From January 2016 to December 2017,patients with obstructive nephropathy of upper urinary calculi were selected and divided into pyonephrosis group and non-pyonephrosis group according to their progression.General clinical data and various laboratory indexes were collected.Univariate analysis was performed on the influencing factors including age,sex,body mass index(BMI),CRP,white blood cell count(WBC),urinary WBC,creatinine(CR),serum albumin(ALB),alanine transaminase(ALT),uric acid(UA),fasting blood glucose(FBG),degree of hydronephrosis,urine culture,serum potassium(K^+).Binary logistic regression analysis was used to analyze the influencing factors of significant correlation.ROC curve was drawn to evaluate the value of risk factors in predicting the progression of upper urinary tract stone obstruction to pyonephrosis.Result:Univariate analysis showed that the level of WBC,urine WBC,CRP were significantly higher in pyonephrosis group than those in non-pyonephrosis group,but the level of BMI and ALB were significantly lower than those in non-pyonephrosis group(P<0.01).Binary logistic regression analysis showed that low BMI,low ALB and CRP were independent risk factors for the progression of upper urinary calculi to pyonephrosis.Their OR and 95%CI were 0.509(0.310-0.836),0.691(0.522-0.915)and 1.189(1.016-1.391),respectively.Peripheral blood and urine WBC had no significant correlation with the progression of obstructive pyonephrosis in upper urinary calculi(P>0.05).ROC curve analysis showed that the AUC of BMI,ALB and CRP were 0.655,0.901 and 0.888,respectively.ALB and CRP were more effective in predicting the progression of upper urinary tract obstruction to pyonephrosis.When the optimal threshold of CRP was 11.94 mg/L,its sensitivity and specificity were 88.89%and 86.79%respectively.Conclusion:Serum CRP level is significantly higher in patients with upper urinary t

关 键 词：C-反应蛋白 上尿路结石 脓肾 危险因素 

分 类 号：R691.3[医药卫生—泌尿科学]