泌尿微创术后患者血浆肌钙蛋白Ⅰ、同型半胱氨酸和降钙素原水平变化及其与术后感染的相关性  

Changes of plasma cTnI,Hcy,PCT levels in patients after minimally invasive urinary surgery and their correlation with postoperative infection

作　　者：何亮[1] 文小平[1] 刘宗利 王小波 郭鹏飞[1] HE Liang;WEN Xiaoping;LIU Zongli;WANG Xiaobo;GUO Pengfei(Depurtment of Urology,Yibin First Pepple's Hospital,Yibin 644000,Sichuan,China;Dqartment of Urology,Pingshan District,Yibin First People's Hospital,Yibin 645350,Sichuan,China)

机构地区：[1]宜宾市第一人民医院泌尿外科,四川宜宾644000 [2]宜宾市第一人民医院屏山院区(屏山县人民医院)泌尿外科,四川宜宾645350

出　　处：《中国性科学》2022年第5期13-17,共5页Chinese Journal of Human Sexuality

摘　　要：目的探究泌尿微创术后患者血浆肌钙蛋白I(cTnI)、同型半胱氨酸(Hcy)和降钙素原(PCT)水平变化及其与术后感染的相关性。方法选取2018年6月至2020年6月于宜宾市第一人民医院行泌尿微创手术的658例患者作为研究对象,根据患者术后是否感染分为感染组(85例)和未感染组(573例)。比较两组患者的基线资料;分析术后感染患者的病原菌分布情况;比较两组治疗前后血浆cTnI、Hcy、PCT水平;采用COX比例风险回归模型和XGboost模型分析影响患者术后感染的因素;绘制受试者工作特征(ROC)曲线分析两种模型的预测效能。结果两组患者的年龄、糖尿病、术前白细胞计数(WBC)、术前尿路感染、手术时间、导尿管滞留时间、住院时间、24h尿量、使用超过3种抗菌药物,以及术后血浆cTnI、Hcy、PCT水平情况比较,差异均具有统计学意义(P<0.05),均是影响患者术后感染的独立危险因素;分离出86株病原菌,其中革兰氏阳性菌占25.58%,革兰氏阴性菌占66.28%,真菌占8.14%;XGboost模型的ROC曲线下面积、灵敏度、特异度、约登指数均明显高于COX比例风险回归模型。结论泌尿微创术后感染患者的血浆cTnI、Hcy、PCT水平显著升高,与术后感染密切相关,对术后感染具有较高的预测价值,对于泌尿微创术后护理具有重要的指导意义。Objective To explore the changes of plasma cardiac troponin I(cTnI),procalcitonin(PCT)and homocysteine(Hcy)levels in patients after minimally invasive urinary surgery and their correlation with postoperative infection.Methods The 658 patients who underwent minimally invasive urinary surgery in Yibin First People′s Hospital from June 2018 to June 2020 were selected as the research objects.According to whether the patients were infected after surgery,the patients were divided into infected group(85 cases)and non-infected group(573 cases).Compare the general data of the two groups of patients;analyze the distribution of pathogenic bacteria in the postoperative infection patients;compare the plasma cTnI,Hcy and PCT levels of the two groups of patients before and after treatment;COX proportional hazard regression model and XGboost model to analyze the factors affecting postoperative infection of patients;ROC curve analysis of the prediction performance of the two models.Results The age,diabetes,preoperative WBC,preoperative urinary tract infection,operation time,catheter retention time,hospitalization time,24-hour urine output,use of>3 antibacterial drugs,postoperative plasma cTnI,Hcy,PCT level difference of the two groups is statistically significant,and they are all independent risk factors affecting postoperative infection of patients.86 pathogenic bacteria were isolated,of which Gram-positive bacteria accounted for 25.58%,Gram-negative bacteria accounted for 66.28%,and fungi accounted for 8.14%.The area under the ROC curve,sensitivity,specificity,and Youden index of the XGboost model are significantly higher than the COX proportional hazards regression model.Conclusions Plasma cTnI,Hcy and PCT levels in patients with minimally invasive urinary surgery infection are significantly increased,which are closely related to postoperative infection,have high predictive value for postoperative infection,and have important guiding significance for postoperative care of minimally invasive urinary surgery.

关 键 词：泌尿微创术 肌钙蛋白I 同型半胱氨酸 降钙素原 感染 相关性 

分 类 号：R691[医药卫生—泌尿科学]