输尿管软镜钬激光碎石术后尿路感染患者血清sTREM-1、RBP4、HBD-3水平变化及检测意义  

Changes and significance of serum sTREM-1,RBP4 and HBD-3 in patients with urinary tract infection after flexible ureteroscopic holmium laser lithotripsy

作　　者：许可欣[1] 时宇绯 沙伟 荀神美 张梅香[1] XU Kexin;SHI Yufei;SHA Wei;XUN Shenmei;ZHANG Meixiang(Laboratory Medicine Center,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学第二附属医院检验医学中心,江苏南京210000

出　　处：《陕西医学杂志》2025年第2期244-247,252,共5页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81802071)。

摘　　要：目的:探讨输尿管软镜钬激光碎石术(FURL)后尿路感染(UTI)患者血清可溶性髓样细胞触发受体-1(sTREM-1)、视黄醇结合蛋白4(RBP4)、人β-防御素-3(HBD-3)水平变化及检测意义。方法:选取行FURL患者183例,根据患者术后是否发生UTI分为UTI组(98例)和非UTI组(85例)。比较两组临床资料及血清sTREM-1、RBP4、HBD-3水平。采用多因素Logistic回归分析患者FURL术后发生UTI的影响因素。分析血清sTREM-1、RBP4、HBD-3对患者FURL术后发生UTI的预测价值。结果:UTI组有泌尿道手术史、导尿管留置时间≥7 d、抗菌药物种类>3种患者比例高于非UTI组(均P<0.05)。UTI组血清sTREM-1、RBP4、HBD-3水平高于非UTI组(均P<0.05)。泌尿道手术史、导尿管留置时间、抗菌药物种类及血清sTREM-1、RBP4、HBD-3是患者FURL术后发生UTI的影响因素(均P<0.05)。血清sTREM-1、RBP4、HBD-3水平与患者泌尿道手术史、导尿管留置时间及抗菌药物种类呈正相关(均P<0.05)。血清sTREM-1、RBP4、HBD-3联合预测患者FURL术后发生UTI的曲线下面积(AUC)为0.894,高于三者独立预测的AUC(均P<0.05)。结论:FURL术后UTI患者血清sTREM-1、RBP4、HBD-3水平升高,三者联合对FURL术后发生UTI具有较高的预测价值。Objective:To investigate the changes in serum levels of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),retinol binding protein 4(RBP4)andβ-defensin-3(HBD-3)in patients with urinary tract infections(UTI)after flexible ureteroscopic holmium laser lithotripsy(FURL),and to assess the significance of these markers.Methods:A total of 183 patients who underwent FURL were selected and divided into two groups based on the occurrence of postoperative UTI:the UTI group(98 cases)and the non-UTI group(85 cases).Clinical data and serum levels of sTREM-1,RBP4,and HBD-3 were compared between the two groups.Multifactorial logistic regression analysis was used to identify factors influencing the occurrence of UTI after FURL.The predictive value of serum sTREM-1,RBP4 and HBD-3 for UTI after FURL was analyzed.Results:The proportion of patients with a history of urinary tract surgery,indwelling catheter time≥7 days,and use of more than three types of antimicrobial drugs was higher in the UTI group compared to the non-UTI group(all P<0.05).Serum levels of sTREM-1,RBP4 and HBD-3 were higher in the UTI group than in the non-UTI group(all P<0.05).A history of urinary tract surgery,indwelling catheter time,types of antimicrobial drugs,and serum levels of sTREM-1,RBP4 and HBD-3 were identified as factors influencing the occurrence of UTI after FURL(all P<0.05).Serum levels of sTREM-1,RBP4 and HBD-3 were positively correlated with the history of urinary tract surgery,indwelling catheter time and types of antimicrobial drugs(all P<0.05).The combined prediction of serum sTREM-1,RBP4 and HBD-3 for UTI following FURL had an area under the curve(AUC)of 0.894,which was higher than the AUC for individual predictions(all P<0.05).Conclusion:Elevated serum levels of sTREM-1,RBP4 and HBD-3 in patients with UTI after FURL,and the combined use of these markers has a high predictive value for the occurrence of UTI after FURL.

关 键 词：尿路感染 输尿管软镜钬激光碎石术 可溶性髓样细胞触发受体-1 视黄醇结合蛋白4 人β-防御素-3 影响因素 预测价值 

分 类 号：R691.3[医药卫生—泌尿科学]