WBC、PGE2、sTERM-1预测mPCNL治疗肾结石后尿源性脓毒症的价值  

Value of WBC,PGE2 and sTERM⁃1 in predicting urinary sepsis after mPCNL for kidney stones

作　　者：刘舟洲 何平林 张汉超[2] 何涌[1] LIU Zhouzhou;HE Pinglin;ZHANG Hanchao;HE Yong(Department of Urology,Sichuan Provincial Building Hospital,Chengdu,Sichuan,China,610000;De-partment of Urology,the Affiliated Hospital of Chengdu University,Chengdu,Sichuan,China,610000)

机构地区：[1]四川省建筑医院泌尿外科,四川成都610000 [2]成都大学附属医院泌尿外科,四川成都610000

出　　处：《分子诊断与治疗杂志》2024年第4期657-660,共4页Journal of Molecular Diagnostics and Therapy

基　　金：成都市医学科研课题(2022051)。

摘　　要：目的探究白细胞(WBC)及前列腺素-2(PGE2)、可溶性髓样细胞表达触发受体-1(sTERM-1)水平预测微创经皮肾镜取石术(m PCNL)治疗肾结石后尿源性脓毒症术后的价值。方法收集2021年12月至2022年12月于四川省建筑医院行mPCNL治疗的146例肾结石患者临床资料,根据术后是否发生尿源性脓毒症分组,分别为A组(术后发生尿源性脓毒症)和B组(术后未发生尿源性脓毒症),均于术后6h内检测WBC、PGE2、sTERM-1,并分析其单独及联合预测尿源性脓毒症的价值。结果146例肾结石患者中,术后17例(11.64%)发生尿源性脓毒症,设为A组,余129例患者设为B组。A组和B组的基线资料比较差异均无统计学意义(P>0.05);A组WBC、PGE2、sTERM-1显著高于B组,差异有统计学意义(P<0.05);经ROC曲线分析,WBC、PGE2、sTERM-1单独及三者联合用于预测mPCNL治疗肾结石后尿源性脓毒症时,其曲线下面积(AUC)分别为0.792、0.847、0.795和0.897,敏感度为0.863、0.804、0.763和0.904,特异度为0.589、0.753、0.753和0.890,联合预测AUC及敏感度显著高于任意一项单独检测(P<0.05)。结论全血WBC及血清PGE2、sTERM-1水平可联合用于预测mPCNL治疗肾结石后尿源性脓毒症的发生,建议术后予以密切监测。Objective To investigate the value of white blood cell(WBC),prostaglandin 2(PGE2)and soluble triggering receptor expressed on myeloid cells⁃1(sTERM⁃1)in predicting urinary sepsis af⁃ter minimally invasive percutaneous nephrolithotomy(mPCNL)for kidney stones.Methods The clinical data of 146 patients with kidney stones who underwent mPCNL at Sichuan Province Building Hospital from Decem⁃ber 2021 to December 2022 were collected.The patients were divided into group A and group B based on wheth⁃er they developed urinary sepsis after the operation.WBC,PGE2 and sTERM⁃1 levels were measured within 6 hours after the operation.The value of these measurements in predicting urinary sepsis was analyzed.Results In this study,17 patients(11.64%)developed urinary sepsis after the operation and were defined as group A.The remaining 129 patients were defined as group B.There was no statistically significant difference in baseline data between the groups(P>0.05).WBC,PGE2 and sTERM⁃1 levels in group A were significantly higher than those in group B(P<0.05).ROC curve analysis showed that the area under the curve(AUC)values for WBC,PGE2,sTERM⁃1,and their combination for predicting urinary sepsis after mPCNL were 0.792,0.847,0.795,and 0.897,respectively.The sensitivity was 0.863,0.804,0.763,and 0.904,while the specificity was 0.589,0.753,0.753 and 0.890.The AUC and sensitivity of the combined prediction were significantly higher than those of single predictions.Conclusion WBC,PGE2 and sTERM⁃1 can be used in combination to predict the occurrence of urinary sepsis after mPCNL for kidney stones.Close monitoring of these indicators is recommend⁃ed after the operation.

关 键 词：WBC PGE2 sTERM-1 MPCNL 肾结石 尿源性脓毒症 

分 类 号：R699.2[医药卫生—泌尿科学]