良性前列腺增生经手术治疗后尿路感染与FasL、Caspase-3、HMGB1和ICAM-1的关系  

Relationship between postoperative urinary tract infection and FasL,Caspase-3,HMGB1 and ICAM-1 of patients with benign prostatic hyperplasia

作　　者：董建设[1] 孙继建 陈瑞廷[1] 白洋洋 贾占奎[2] DONG Jian-she;SUN Ji-jian;CHEN Rui-ting;BAI Yang-yang;JIA Zhan-kui(Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450053,China;不详)

机构地区：[1]河南省中医院泌尿外科,河南郑州450053 [2]郑州大学第一附属医院泌尿外科,河南郑州450000

出　　处：《中华医院感染学杂志》2024年第10期1517-1521,共5页Chinese Journal of Nosocomiology

基　　金：河南省中医药科学研究专项课题(2019ZY2043)。

摘　　要：目的分析良性前列腺增生(BPH)患者经手术治疗后尿路感染(UTI)与凋亡相关因子配体(FasL)、半胱氨酸蛋白酶-3(Caspase-3)、高迁移率族蛋白B1(HMGB1)和细胞间黏附分子-1(ICAM-1)的关系。方法选择2020年1月-2022年12月在河南省中医院接受治疗的306例BPH患者,将手术治疗后46例发生UTI患者纳入感染组,260例未发生UTI的患者纳入未感染组,采用多因素Logistic回归分析BPH患者术后发生UTI的危险因素,受试者工作特征(ROC)曲线分析FasL、Caspase-3、HMGB1和ICAM-1对BPH患者术后发生UTI的诊断价值。结果多因素Logistic回归分析结果显示,BPH患者经手术治疗后发生UTI的独立危险因素包括高龄、糖尿病史、术前留置导尿管、初学医师行手术操作(P<0.05);感染组FasL蛋白低于未感染组(P<0.05),Caspase-3蛋白及血清HMGB1、ICAM-1水平均高于未感染组(P<0.05);FasL、Caspase-3、HMGB1和ICAM-1联合诊断BPH患者术后发生UTI的曲线下面积(AUC)为0.944,敏感度和特异度分别为91.30%和86.54%。结论年龄大、有糖尿病史、术前留置导尿管、初学医师行手术均是BPH患者术后发生UTI的危险因素,FasL、Caspase-3、HMGB1和ICAM-1检测预测术后发生UTI的价值较高。OBJECTIVE To analyze the relationship between the postoperative urinary tract infection(UTI)and the factor apoptosis-related ligand(FasL),cysteine proteinase-3(Caspase-3),high mobility group protein B1(HMGB1)and intercellular adhesion molecule-1(ICAM-1)of the patients with benign prostatic hyperplasia(BPH).METHODS A total of 306 patients with BPH who were treated in Henan Provincial Hospital of Traditional Chinese Medicine from Jan 2020 to Dec 2022 were enrolled in the study,46 of whom had postoperative UTI and were assigned as the infection group,260 did not have UTI and were assigned as the no infection group.Multivariate logistic regression analysis was performed for the risk factors for the postoperative UTI in the BPH patients,and the values of FasL,Caspase-3,HMGB1 and ICAM-1 in diagnosis of the postoperative UTI were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The result of multivariate logistic regression analysis showed that the independent risk factors for the postoperative UTI in the BPH patients included the advanced age,history of diabetes mellitus,preoperative urinary catheter indwelling,surgical procedures executed by physician beginners(P<0.05).The FasL level of the infection group was significantly lower than that of the no infection group(P<0.05),the levels of Caspase-3,serum HMGB1 and ICAM level of the infection group were significantly higher than those of the no infection group(P<0.05).The area under curve(AUC)of the joint detection of FasL,Caspase-3,HMGB1 and ICAM-1 was 0.944 in diagnosis of the postoperative UTI in the BPH patients,with the sensitivity 91.30%,the specificity 86.54%.CONCLUSION The advanced age,history of diabetes mellitus,preoperative urinary catheter indwelling and physician beginners′operation are the risk factors for the postoperative UTI in the BPH patients.The FasL,Caspase-3,HMGB1 and ICAM-1 have high values in prediction of postoperative UTI.

关 键 词：良性前列腺增生 尿路感染 凋亡相关因子配体 半胱氨酸蛋白酶-3 高迁移率族蛋白B1 细胞间黏附分子-1 

分 类 号：R699.8[医药卫生—泌尿科学]