输尿管结石术后患者的血IL-6、CRP、TNF-α表达及对并发感染的预测价值  

ROC curve analysis of the significance of blood IL-6,CRP and TNF-αexpression in patients after ureteral calculi and the predictive value of infection complications

作　　者：冯越 薛荣波 余波 许强 Feng Yue;Xue Rongbo;Yu Bo;Xu Qiang(Department of Urology,the Affiliated Hospital of Panzhihua University,Panzhihua 617000,China;Department of Urology,the Second Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]攀枝花学院附属医院泌尿外科,攀枝花617000 [2]遵义医科大学第二附属医院泌尿外科,遵义563000

出　　处：《国际泌尿系统杂志》2024年第1期88-93,共6页International Journal of Urology and Nephrology

基　　金：四川省科技计划项目(2018JDR3697)。

摘　　要：目的探讨输尿管结石术后患者的血白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)表达及对并发感染的预测价值。方法选取2021年2月至2022年5月攀枝花学院附属医院收治的61例输尿管结石术后感染患者设为研究组,另选取61例术后无感染患者设为对照组。比较两组不同感染情况患者的IL-6、CRP、TNF-α水平,分析血清指标与输尿管结石术后感染、病情情况的关联性及对术后感染的预测价值。结果术后即刻、术后6 h、术后24 h研究组的IL-6、CRP、TNF-α血清水平均高于对照组(均P<0.05);术后6 h研究组IL-6、CRP、TNF-α血清水平较术后即刻增高,术后24 h研究组的IL-6、CRP、TNF-α血清水平较术后6 h降低(均P<0.05);术后6 h、24 h对照组的IL-6、CRP、TNF-α血清水平较术后即刻降低(均P<0.05);术后不同时间段的血清IL-6、CRP、TNF-α水平与输尿管结石术后感染具有显著相关性(均P<0.05);术后6 h时血IL-6、TNF-α的截断值和灵敏度相对较高,分别为85.25%、68.85%;选择术后6 h时的血清IL-6、CRP、TNF-α水平作为联合预测指标,受试者工作特征(ROC)曲线分析的曲线下面积(AUC)为0.901,灵敏度为85.25%,特异度为85.25%;术后6 h全身感染者的IL-6、CRP、TNF-α水平高于局部感染者(P<0.05);不同病情程度感染患者的IL-6、CRP、TNF-α水平存在显著差异,且随病情程度增加其水平持续增高(均P<0.05);术后6 h的血清IL-6、CRP、TNF-α水平与感染情况、病情程度呈正相关(均P<0.05)。结论血IL-6、CRP、TNF-α水平变化可作为输尿管结石术后是否发生感染的预测指标,并能协助评估感染严重程度,检测上述因子变化有助于完善治疗方案。Objective To investigate the expression of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)in patients after ureteral calculi and their predictive value for infection complications.Methods From February 2021 to May 2022,61 patients with infection after ureteral calculi in our hospital were selected as the study group and 61 patients without infection were set as the control group.The levels of IL-6,CRP and TNF-αwere compared between the two groups of patients with different infection conditions,and the correlation between serum indexes and postoperative infection and disease conditions and the predictive value of postoperative infection were analyzed.Results Immediately after surgery,6 hours after surgery,and 24 hours after surgery,the levels of serum IL-6,CRP,and TNF-αin the control group showed a decreasing trend,and the study group showed a single-peak trend,the serum levels of IL-6,CRP and TNF-αin the study group were higher than those in the control group(all P<0.05).The levels of serum IL-6,CRP and TNF-αat different time periods after operation were significantly associated with postoperative infection of ureteral calculi(all P<0.05).The sensitivity of the cutoff values of IL-6 and TNF-αat 6 hours after surgery was relatively high(85.25%vs.68.85%).Serum IL-6,CRP and TNF-αlevels were selected as joint prediction at 6 hours after operation.ROC curve analysis showed that AUC was 0.901,sensitivity was 85.25%,and specificity was 85.25%,and the levels of IL-6,CRP,and TNF-αwere higher in patients with systemic infection at 6 hours after surgery than those with local infection(P<0.05).The levels of IL-6,CRP and TNF-αin patients with different degrees of infection were significantly different,and their levels continued to increase with the increase of the degree of disease(all P<0.05).There was a positive correlation between the levels of serum IL-6,CRP,and TNF-αat 6 hours after surgery and the infection and the degree of illness(all P<0.05).Conclusions The changes of IL-6,CRP an

关 键 词：输尿管结石 白介素-6 C反应蛋白 肿瘤坏死因子-α 感染 

分 类 号：R699.4[医药卫生—泌尿科学]