肾结石合并非酒精性脂肪性肝病患者术后感染的影响因素及预测  

Influencing factors and prediction of postoperative infection in patients with renal stones complicated by non-alcoholic

作　　者：王硕 陆攀 叶昶 WANG Shuo;LU Pan;YE Chang(Postgraduate Training Base of Xiaogan Central Hospital,Jinzhou Medical University,Xiaogan,Hubei,432000,China;Department of Urology,Xiaogan Central Hospital)

机构地区：[1]锦州医科大学孝感市中心医院研究生培养基地,湖北孝感432000 [2]孝感市中心医院泌尿外科

出　　处：《临床泌尿外科杂志》2024年第1期78-82,共5页Journal of Clinical Urology

摘　　要：目的:探讨当肾结石患者合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)术后发生感染的影响因素及预测。方法:回顾性分析2020年3月—2023年3月孝感市中心医院收治120例肾结石合并NAFLD患者,以术后是否发生感染分为感染组和非感染组。收集2组患者的临床资料,分析当肾结石患者合并NAFLD时术后发生感染的影响因素,并建立相关预测模型。结果:120例肾结石合并NAFLD患者,术后有27例发生感染,93例未发生感染。单因素分析显示,性别、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)、甘油三酯、预后营养指数(prognostic nutritional index, PNI)、肝功能异常和手术方式与肾结石合并NAFLD术后感染差异有统计学意义(P<0.05),而年龄、血肌酐水平和手术时间则差异无统计学意义(P>0.05)。多因素回归分析显示,性别、NLR、甘油三酯、肝功能异常和手术方式是肾结石合并NAFLD患者发生术后感染的独立危险因素,而PNI是此类患者发生术后感染的独立保护性因素(P<0.05)。此外,受试者工作曲线分析结果显示,甘油三酯水平与NLR和PNI三者组合对肾结石合并NAFLD术后感染具有最高的预测价值(曲线下面积0.834,特异度0.889,灵敏度0.645)。结论:性别、NLR、甘油三酯、PNI、肝功能异常和手术方式是肾结石合并NAFLD患者术后感染发生的影响因素,同时对此类患者具有一定的预测价值。尤其是NLR、甘油三酯和PNI的组合显示出更强的预测效果。针对这些影响因素进行有效的临床干预对于改善治疗效果和提高患者预后具有重要意义。Objective To explore the influencing factors and prediction of postoperative infection in patients with renal stones complicated by non-alcoholic fatty liver disease(NAFLD).Methods We conducted a retrospective analysis of 120 patients admitted to Xiaogan Central Hospital who had renal stones combined with NAFLD.These patients were divided into two groups:infected and non-infected,based on whether postoperative infection occurred.We collected clinical data from both groups to analyze the factors that influenced the occurrence of postoperative infection in patients with renal stones combined with NAFLD.Our aim is to establish a prediction model that is relevant to this scenario.Results In 120 patients with renal stones combined with NAFLD,27 had postoperative infections and 93 did not.Univariate analysis showed that gender,neutrophil-to-lymphocyte ratio(NLR),triglyceride,prognostic nutritional index(PNI),liver function abnormality,and surgical modality were statistically significantly associated with postoperative infections in renal stones combined with NAFLD(P<0.05),while age,blood creatinine level,or surgical time were not statistically significant(P>0.05).Multifactorial regression analysis showed that gender,NLR,triglyceride,abnormal liver function and surgical procedure were independent risk factors for postoperative infections in patients with kidney stones combined with NAFLD,while PNI was an independent protective factor for postoperative infections in such patients(P<0.05).In addition,the results of the receiver operating characteristic curve analysis of the subjects showed that the triple combination of triglyceride level,NLR and PNI had the highest predictive value for postoperative infections in kidney stones combined with NAFLD(area under the curve 0.834,specificity 0.889,sensitivity 0.645).Conclusion Gender,NLR,triglyceride,PNI,abnormal liver function,and surgical method were identified as influencing factors for the occurrence of infection in patients with kidney stones combined with NAFLD.These fact

关 键 词：肾结石 非酒精性脂肪性肝病 术后感染 影响因素 预测 

分 类 号：R692.4[医药卫生—泌尿科学]