血清PCT及NGAL评估F4.8 PCNL术对肾结石患者肾功能的影响  

Effect of serum PCT and NGAL on renal function in patients with nephrolithiasis after F4.8 PCNL surgery

作　　者：安丰[1] 郭景阳[2] 路璐[1] 师晓强[1] 崔振宇[1] 索勇[1] AN Feng;GUO Jingyang;LU Lu;SHI Xiaoqiang;CUI Zhenyu;SUO Yong(Department of Urology,the Affiliated Hospital of Hebei University,Baoding,Hebei,China,071000;Department of Anesthesiology,the Affiliated Hospital of Hebei University,Baoding,Hebei,China,071000)

机构地区：[1]河北大学附属医院泌尿外科,河北保定071000 [2]河北大学附属医院麻醉科,河北保定071000

出　　处：《分子诊断与治疗杂志》2023年第1期30-33,38,共5页Journal of Molecular Diagnostics and Therapy

基　　金：保定市科技计划项目(18ZF184)。

摘　　要：目的 探讨血清降钙素原(PCT)及中性粒细胞明胶酶相关载脂蛋白(NGAL)评估F4.8经皮肾镜术(F4.8 PCNL)对肾结石患者肾功能的影响。方法 选取2019年1月至2021年12月河北大学附属医院收治的肾结石患者84例做为研究对象,并根据术后早期(术后48 h内)是否发生肾功能下降分为观察组(肾功能下降,n=37)和对照组(肾功能未下降,n=47)。比较两组患者术前血清PCT及NGAL水平,采用Spearman相关性分析分析血清PCT及NGAL对与F4.8 PCNL术肾结石患者肾功能下降的相关性。采用多因素Logistic回归分析F4.8 PCNL术肾结石患者肾功能下降的独立影响因素,并采用ROC曲线评估血清PCT及NGAL预测F4.8 PCNL术后肾结石患者肾功能下降。结果 观察组术前肾小球滤过率明显低于对照组,PCT及NGAL水平均高于对照组,差异有统计学意义(t=8.598、5.318、7.762,P<0.05);经Spearman相关性分析显示,术前PCT及NGAL与F4.8 PCNL术后肾结石患者肾功能下降呈正相关(P<0.05);Logistic多因素回归分析结果显示,术前PCT及NGAL均为F4.8 PCNL术后肾结石患者肾功能下降的独立影响因素(P<0.05),且ROC曲线显示,术前PCT、NGAL以及联合检测预测F4.8 PCNL术后肾结石患者肾功能下降的曲线下面积(AUC)分别为0.716、0.692、0.743、0.753、0.897。结论 术前PCT及NGAL水平评估F4.8 PCNL术后肾结石患者肾功能下降均具有较高的临床价值,且联合检测可以为临床预测F4.8 PCNL术对肾结石患者肾功能的影响提供参考依据。Objective To investigate the effect of serum procalcitonin(PCT)and neutrophil gelatinase associated apolipoprotein(NGAL)on renal function in patients with renal calculi after F4.8 percutaneous nephroscopy(F4.8 PCNL). Methods 84 patients with renal calculi from January 2019 to December 2021were selected as the study objects,and divided into the observation group(renal function decreased,n=37)and the control group(renal function not decreased,n=47)according to whether there was renal function decline in the early postoperative period(within 48 hours after operation). The levels of serum PCT and NGAL were compared between the two groups before operation. Spearman correlation analysis was used to analyze the correlation between serum PCT and NGAL and the decline of renal function in patients with F4.8 PCNL renal calculi. Multivariate logistic regression was used to analyze the independent influencing factors of renal function decline in patients with renal calculi after F4.8 PCNL,and the ROC curve was used to evaluate serum PCT and NGAL to predict renal function decline in patients with renal calculi after F4.8 PCNL. Results The glomerular filtration rate in the observation group was significantly lower than that in the control group,and the levels of PCT and NGAL were higher than those in the control group(t=8.598,5.318,7.762,P<0.05).Spearman correlation analysis showed that PCT and NGAL before operation were positively correlated with the decline of renal function in patients with renal calculi after F4.8 PCNL(P<0.05). Logistic multivariate regression analysis showed that PCT and NGAL before operation were independent influencing factors of renal function decline in patients with renal calculi after F4.8 PCNL(P<0.05),and the ROC curve showed that the area under the curve(AUC)of PCT,NGAL and joint detection predicting renal function decline in patients with renal calculi after F4.8 PCNL were 0.716,0.692,0.743,0.753 and 0.897 respectively. Conclusion Preoperative PCT and NGAL levels have a high clinical value in eval

关 键 词：血清降钙素原 中性粒细胞明胶酶相关载脂蛋白 F4.8 PCNL 肾功能 

分 类 号：R699.2[医药卫生—泌尿科学]