血清HBD-3、DCR3对复杂性肾结石患者经皮肾镜碎石术后尿路感染的预测价值  

Nephrolithotomy in patients with complex kidney calculi

作　　者：魏峰[1] 周广军[1] 李双辉[1] 王艳艳 季智杰 WEI Feng;ZHOU Guangjun;LI Shuanghui;WANG Yanyan;JI Zhijie(Department of Urology,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院泌尿外科,河北沧州061000

出　　处：《现代泌尿外科杂志》2024年第4期342-346,共5页Journal of Modern Urology

基　　金：沧州市科学技术局项目(No.222106081)。

摘　　要：目的分析血清β-防御素-3(HBD-3)、诱骗受体3(DCR3)对复杂性肾结石患者经皮肾镜碎石术后尿路感染的预测价值。方法选取2020年1月—2022年12月河北省沧州中西医结合医院收治的112例复杂性肾结石患者为研究对象进行回顾性研究,所有患者均行经皮肾镜碎石术(PCNL),根据术后感染情况将患者分为非尿路感染组52例、尿路感染组60例。比较两组一般资料及HBD-3、DCR3水平。受试者工作特征(ROC)曲线分析C反应蛋白(CRP)、降钙素原(PCT)、HBD-3、DCR3水平对术后尿路感染的预测价值。结果与非尿路感染组比较,尿路感染组的HBD-3[(0.77±0.08)ng/mL vs.(1.36±0.25)ng/mL,P=0.001]、DCR3[(4.68±0.53)ng/mL vs.(13.21±0.28)ng/mL,P=0.001]水平较高。多因素logistics回归分析显示,泌尿道手术史、术前尿路感染、手术时间、导尿管留置时间、结石负荷、抗菌药物种类、合并肾功能障碍、术中通道类型CRP、PCT、HBD-3、DCR3为患者术后尿路感染的影响因素(P<0.05)。ROC曲线显示,CRP、PCT、CRP联合PCT准确度分别为70.54%、72.32%、78.57%;HBD-3、DCR3、HBD-3联合DCR3准确度分别为69.64%、75.89%、86.61%。结论复杂性肾结石患者术后尿路感染与多种因素相关,且术后尿路感染患者HBD-3、DCR3表达水平较高,联合检测对术后尿路感染具有较高的预测价值。Objective To analyze the predictive value of serumβ-defensin-3(HBD-3)and decoy receptor 3(DCR3)for urinary tract infection after percutaneous nephrolithotomy(PCNL)in patients with complex kidney calculi.Methods A prospective study was conducted on 112 patients treated with PCNL at our hospital during Jan.2020 and Dec.2022.The patients were divided into the non-infection group(52 cases)and infection group(60 cases).The general data,HBD-3 and DCR3 levels of the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of C reactive protein(CRP),procalcitonin(PCT),HBD-3 and DCR3 levels for postoperative urinary tract infection.Results Compared with the non-infection group,the infection group had higher levels of HBD-3[(0.77±0.08)ng/mL vs.(1.36±0.25)ng/mL,P=0.001]and DCR3[(4.68±0.53)ng/mL vs.(13.21±0.28)ng/mL,P=0.001].Multivariate logistic regression showed that a history of urinary tract surgery,preoperative urinary tract infection,operation time,catheterization time,stone load,type of antibiotics,concomitant renal dysfunction,intraoperative channel type,CRP,PCT,HBD-3 and DCR3 were risk factors of postoperative urinary tract infection(P<0.05).The ROC curve showed that the accuracy of CRP,PCT,and CRP plus PCT were 70.54%,72.32%,and 78.57%,respectively;the accuracy of HBD-3,DCR3,and HBD-3 plus DCR3 were 69.64%,75.89%,and 86.61%,respectively.Conclusion Postoperative urinary tract infection in patients with complex kidney calculi is associated with multiple factors,especially high expression levels of HBD-3 and DCR3.Combined detection has high predictive value.

关 键 词：复杂性肾结石 经皮肾镜碎石术 β-防御素-3 诱骗受体3 尿路感染 C反应蛋白 降钙素原 

分 类 号：R692.4[医药卫生—泌尿科学]