梗阻性上尿路感染进展为严重脓毒症的危险因素分析  

Risk factors in progression to severe sepsis in patients with obstructive upper urinary tract infection

作　　者：王徽 戴宇红[1] 鲍彤[1] WANG Hui;DAI Yuhong;BAO Tong(Department of Urology,Affiliated Anqing Municipal Hospital of Anhui Medical University,Anqing,Anhui,246003,China)

机构地区：[1]安徽医科大学附属安庆医院泌尿外科,安徽安庆246003

出　　处：《临床泌尿外科杂志》2024年第10期918-921,共4页Journal of Clinical Urology

摘　　要：目的:探讨梗阻性上尿路感染进展为严重脓毒症的危险因素,为临床早期识别高危患者提供依据。方法:回顾性分析2020年1月—2023年3月安徽医科大学附属安庆医院收治的67例梗阻性上尿路感染患者的临床资料,根据是否进展为严重脓毒症或脓毒性休克,将其分为研究组(36例)和对照组(31例)。比较2组患者的一般资料、合并症、感染相关指标等,采用单因素和多因素logistic回归分析筛选独立危险因素。结果:与对照组相比,研究组患者的糖尿病比例、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血肌酐、C反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)水平显著升高,而血小板计数和血清白蛋白水平明显降低(P<0.05)。多因素logistic回归分析显示,PCT是梗阻性上尿路感染进展为严重脓毒症的独立危险因素(OR=1.101,P<0.001)。结论:PCT是评估梗阻性上尿路感染进展为严重脓毒症的独立危险因素。对于急诊收治的此类患者,应密切监测PCT、NLR、血小板计数、血清白蛋白等指标,以期早期识别高危患者,及时干预,改善预后。Objective To investigate the risk factors in progression to severe sepsis in patients with obstructive upper urinary tract infection, and to provide evidence for early identification of high-risk patients in clinical practice.Methods The clinical data of 67 obstructive upper urinary tract infection patients admitted to Affiliated Anqing Municipal Hospital of Anhui Medical University from January 2020 to March 2023 were retrospectively analyzed. According to whether they progressed to severe sepsis or septic shock, the patients were divided into a case group(n=36) and a control group(n=31). The general information, comorbidities, infection-related indicators and other data were compared between the two groups. Univariate and multivariate logistic regression analyses were used to screen independent risk factors.Results Compared with the control group, the case group had a significantly higher proportion of diabetes, neutrophil-to-lymphocyte ratio(NLR), serum creatinine, C-reactive protein(CRP) and procalcitonin(PCT) levels, while platelet count and serum albumin levels were significantly lower(P < 0.05). Multivariate logistic regression analysis showed that PCT was an independent risk factor in progression to severe sepsis in obstructive upper urinary tract infection patients(OR=1.101, P < 0.001).Conclusion PCT is an independent risk factor in assessing the progression to severe sepsis in patients with obstructive upper urinary tract infection. For such patients admitted to the emergency department, close monitoring of PCT, NLR, CRP, platelet count, serum albumin and other indicators should be performed to identify high-risk patients early, intervene timely, and improve prognosis.

关 键 词：梗阻性上尿路感染 脓毒症 危险因素 降钙素原 

分 类 号：R691.3[医药卫生—泌尿科学]