尿液白介素-6和肿瘤坏死因子-α表达水平与输尿管结石钬激光碎石术后输尿管痉挛的相关性研究  

Study on the relationship between the expression levels of interleukin-6 and tumor necrosis factor-αin urine and uretero spasm after holmium laser lithotripsy for ureteral calculus

作　　者：高景宇[1] 王磊[1] 罗子靖[1] 徐哲 张晔[1] Gao Jingyu;Wang Lei;Luo Zijing;Xu Zhe;Zhang Ye(Department of Urology Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院泌尿外科,石家庄050031

出　　处：《中国医学前沿杂志（电子版）》2020年第12期76-80,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2018年度河北省医学科学研究重点课题计划(20180242)。

摘　　要：目的探讨尿液白介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达水平与输尿管结石钬激光碎石术后输尿管痉挛的相关性。方法选取2019年6月至2020年6月河北医科大学第一医院收治的120例输尿管结石患者为研究对象,根据钬激光碎石术后是否发生输尿管痉挛将其分为无输尿管痉挛组(67例)和输尿管痉挛组(53例)。采用酶联免疫吸附测定检测两组患者尿液IL-6和TNF-α的表达水平,采用Pearson相关性分析探讨输尿管痉挛患者尿液IL-6和TNF-α表达水平与输尿管痉挛发生时间、每次持续时间的相关性,采用多因素Logistic回归分析筛选导致输尿管结石患者钬激光碎石术后输尿管痉挛的危险因素,并采用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析联合检测尿液IL-6和TNF-α表达水平对输尿管结石钬激光碎石术后输尿管痉挛的预测价值。结果术后1 d,两组患者尿液IL-6和TNF-α表达水平均显著高于本组术前(均P<0.05),且输尿管痉挛组患者尿液IL-6和TNF-α表达水平均显著高于无输尿管痉挛组(均P<0.05)。输尿管痉挛组不同结石位置患者尿液IL-6和TNF-α表达水平由高至低依次为下段、中段、上段,两两比较差异均具有统计学意义(均P<0.05)。术后1 d,输尿管痉挛组患者尿液IL-6和TNF-α表达水平与痉挛发生时间均呈负相关(均P<0.001),与痉挛每次持续时间均呈正相关(均P<0.001)。多因素Logistic回归分析显示,尿液IL-6和TNF-α表达水平升高是导致输尿管结石患者钬激光碎石术后输尿管痉挛的独立危险因素(均P<0.05)。ROC曲线分析显示,联合检测尿液IL-6和TNF-α表达水平预测输尿管结石患者钬激光碎石术后输尿管痉挛的曲线下面积为0.920,灵敏度为90.60%,特异度为85.70%。结论尿液IL-6和TNF-α表达水平可作为评估输尿管结石钬激光碎石术后输尿管痉挛的检测指标。Objective To investigate the relationship between the expression levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in urine and uretero spasm after holmium laser lithotripsy for ureteral calculus.Method A total of 120 patients with ureteral calculus treated in the First Hospital of Hebei Medical University from June 2019 to June 2020 were selected for the study.According to the occurrence of uretero spasm after holmium laser lithotripsy,the patients were divided into non-uretero spasm group(n=67)and uretero spasm group(n=53).The expression levels of IL-6 and TNF-αin urine of the two groups were detected by enzyme-linked immunosorbent assay,the correlation between the expression levels of IL-6 and TNF-αin urine and the time and duration of uretero spasm in patients with uretero spasm were explored by Pearson correlation analysis,multivariate Logistic regression analysis was used to screen the risk factors of uretero spasm after holmium laser lithotripsy in patients with ureteral calculus,the receiver operator characteristic curve(ROC curve)was used to analyze the combined detection of IL-6 and TNF-αexpression levels in urine to predict uretero spasm after holmium laser lithotripsy for ureteral calculus.Result One day after operation,the expression levels of IL-6 and TNF-αin urine of both groups were significantly higher than those before operation(all P<0.05),and the expression levels of IL-6 and TNF-αin urine in uretero spasm group were significantly higher than those in nonuretero spasm group(all P<0.05).The expression levels of IL-6 and TNF-αin urine of patients with uretero spasm were lower,middle and upper segments from high to low,and there were significant differences between them(all P<0.05).One day after operation,the expression levels of IL-6 and TNF-αin urine in uretero spasm group were negatively correlated with the time of spasm(all P<0.001),and positively correlated with the duration of spasm(all P<0.001).Multivariate Logistic regression analysis showed that the increased expres

关 键 词：输尿管结石 钬激光碎石术 输尿管痉挛 白介素-6 肿瘤坏死因子-Α 

分 类 号：R699.4[医药卫生—泌尿科学]