双期增强CT扫描联合血浆Presepsin水平对急性肾盂肾炎的诊断价值  

Diagnostic value of two-phase contrast-enhanced CT combined with the plasma level of presepsin for acute pyelonephritis

作　　者：邹琪[1] 黎志鹏 鲁广亮 Zou Qi;Li Zhi-peng;Lu Guang-iang(Department of Urology,The First People's Hospital of Fuzhou,Fuzhou,Jiangxi 344000,China;Department of Emergency,High-tech District of the First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330036,China;Department of Imaging,The First People's Hospital of Fuzhou,Fuzhou,Jiangxi 344000,China)

机构地区：[1]抚州市第一人民医院泌尿外科,江西抚州344000 [2]南昌大学第一附属医院高新区急诊科,江西南昌330036 [3]抚州市第一人民医院影像科,江西抚州344000

出　　处：《中国现代医学杂志》2023年第24期12-16,共5页China Journal of Modern Medicine

基　　金：江西省自然科学基金(No:20212BAB206062);江西省卫生健康委科研课题(No:20194090)。

摘　　要：目的 探讨双期增强CT扫描联合血浆Presepsin水平在急性肾盂肾炎(APN)中的诊断价值。方法回顾性分析2019年3月—2020年5月抚州市第一人民医院收治的95例尿路感染患者的临床资料。根据临床诊断将其分成非APN组(42例)与APN组(53例)。53例APN患者根据病情严重程度分为非重症组(34例)与重症组(19例)。比较APN组与非APN组患者一般资料、血浆Presepsin水平,比较重症组与非重症组血浆Presepsin水平。比较双期增强CT扫描结果与临床诊断结果,比较双期增强CT扫描联合血浆Presepsin水平诊断结果与临床诊断结果。绘制受试者工作特征(ROC)曲线,分析双期增强CT扫描联合血浆Presepsin水平对APN的诊断价值。结果APN组与非APN组患者性别构成、年龄、尿路感染病程、体质量指数比较,差异均无统计学意义(P>0.05)。APN组血浆Presepsin水平高于非APN组(P <0.05),重症组血浆Presepsin水平高于非重症组。双期增强CT扫描结果与临床诊断的一致性一般(Kappa=0.725,P=0.012),双期增强CT扫描检查联合血浆Presepsin水平与临床诊断的一致性较好(Kappa=0.798,P=0.005)。ROC曲线结果分析显示,双期增强CT扫描、血浆Presepsin水平及两者联合诊断APN的敏感性分别为88.68%(95%CI:0.767,0.923)、79.25%(95%CI:0.673,0.865)、93.34%(95%CI:0.634,0.978),特异性分别为73.81%(95%CI:0.528,0.835)、71.43%(95%CI:0.501,0.827)、90.48%(95%CI:0.696,0.982),曲线下面积分别为0.812(95%CI:0.719,0.885)、0.717(95%CI:0.615,0.804)、0.924(95%CI:0.851,0.968)。结论 双期增强CT扫描、血浆Presepsin水平可用于诊断APN,且两者联合具有更高的诊断价值。Objective To investigate the diagnostic value of two-phase contrast-enhanced CT combined with the plasma level of soluble cluster of differentiation 14 subtype(presepsin)for acute pyelonephritis(APN).Methods The clinical data of 95 patients with urinary tract infection admitted to The First People's Hospital of Fuzhou from March 2019 to May 2020 were retrospectively analyzed.According to the clinical diagnosis,the patients were divided into the non-APN group(n=42)and the APN group(n=53),and those with APN were subdivided into the non-critical group(n=34)and the critical group(n=19)according to the severity of the disease.The general data and the plasma level of presepsin were compared between the APN group and the non-APN group,and the plasma level of presepsin was also compared between the critical group and the non-critical group.The consistency between the findings of the two-phase contrast-enhanced CT and the clinical diagnosis was analyzed,and the diagnosis made via the findings of the two-phase contrast-enhanced CT combined with the plasma level of presepsin was compared with the clinical diagnosis as well.The receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of two-phase contrast-enhanced CT combined with the plasma level of presepsin for APN.Results There was no difference in sex composition,age,duration of urinary tract infection and body mass index between the APN group and the non-APN group(P>0.05).The plasma level of presepsin in the APN group was higher than that in the non-APN group(P<0.05),and the plasma level of presepsin in the critical group was higher compared with that in the non-critical group(P<0.05).The consistency between findings of the two-phase contrast-enhanced CT and the clinical diagnosis was fair(Kappa=0.725,P=0.012),while the consistency between the diagnosis made via the findings of the two-phase contrast-enhanced CT combined with the plasma level of presepsin and the clinical diagnosis was good(Kappa=0.798,P=0.005).ROC curve analysis revealed

关 键 词：急性肾盂肾炎 双期增强CT扫描 Presepsin 诊断价值 

分 类 号：R692.7[医药卫生—泌尿科学]