上尿路感染性结石与临床危险因素的相关性研究  

Correlation between infectious stones in the upper urinary tract and clinical risk factors

作　　者：郭宗保 刘洪新 殷金成 唐新宇 沈俭 GUO Zong⁃bao;LIU Hong⁃xin;YIN Jin⁃cheng;TANG Xin⁃yu;SHEN Jian(Department of Urology,Chongming Hospital Affiliated to Shanghai Health Medical College,Shanghai 202150,China)

机构地区：[1]上海健康医学院附属崇明医院泌尿外科,上海202150

出　　处：《哈尔滨医科大学学报》2024年第5期488-492,共5页Journal of Harbin Medical University

基　　金：上海市科学技术委员会科技计划项目(21Y11904100);上海健康医学院附属崇明医院科研基金项目(CMYY2023-25)

摘　　要：目的 探讨上尿路结石合并感染患者的临床危险因素,通过分析其临床特征与实验室检查结果,建立临床预测模型,指导临床诊疗决策。方法 回顾性收集2021年2月~2024年1月上海健康医学院附属崇明医院泌尿外科收治的212例上尿路感染性结石患者的临床资料。根据感染程度分为轻度感染组133例、中重度感染组79例,收集并分析性别、年龄、身体质量指数(body mass index, BMI)等一般资料以及结石病史、梗阻情况、体温、血清白细胞介素6(interleukin 6,IL-6)、C反应蛋白(C-reactive protein, CRP)与白蛋白(albumin, Alb)比值(CRP/AIb)等病史资料。检验指标包括血尿常规、肾功能、血尿酸、尿培养等。Logistic回归分析影响上尿路结石合并感染预后的独立危险因素。结果 单因素分析显示,尿液中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin, NGAL)和血清IL-6、CRP/Alb、干扰素γ诱导蛋白10(interferon gamma-induced protein 10,IP-10)与感染程度密切相关(P<0.05)。Logistic回归分析显示尿液NGAL和血清IL-6、CRP/Alb、IP-10、为上尿路结石中重度感染的独立危险因素。受试者工作特征曲线(receiver operating characteristic curve, ROC曲线)结果显示,尿液NGAL和血清IL-6、CRP/Alb、IP-10以及联合诊断上尿路结石中重度感染的曲线下面积(area under the curve, AUC)分别为0.872、0.828、0.904、0.717、0.989。结论 本研究建立的临床预测模型能有效识别上尿路结石患者中重度感染的临床危险因素,为临床医生制定个体化治疗计划提供了科学依据。Objective To investigate the clinical risk factors of patients with upper urinary tract stones combined with infection,and to establish a clinical prediction model to guide clini⁃cal diagnosis and treatment decisions by analyzing their clinical characteristics and laboratory examination results.Methods A retrospective collection of clinical data was performed on 212 patients with infectious stones in the upper urinary tract treated in the Department of Urology of Chongming Hospital Affiliated to Shanghai Health Medical College from February 2021 to Janu⁃ary 2024.The patients were divided into a mild infection group(133 cases)and a moderate to severe infection group(79 cases).Data were collected and analyzed included general informa⁃tion such as gender,age,body mass index(BMI),as well as medical history like stone histo⁃ry,obstruction condition,body temperature,serum levels of interleukin 6(IL⁃6),the ratio of C⁃reactive protein(CRP)to Albumin(Alb)(CRP/Alb),etc.Laboratory tests included rou⁃tine urinalysis,renal function,blood uric acid,urine culture,among others.Logistic regres⁃sion analysis was used to explore independent risk factors affecting the prognosis of infectious stones in the upper urinary tract.Results Univariate analysis showed that urinary neutrophil gelatinase⁃associated lipocalin(NGAL),and serum IL⁃6,CRP/Alb,interferon gamma⁃induced protein 10(IP⁃10)were closely related to the degree of infection(P<0.05).Logistic regres⁃sion analysis further identified urinary NGAL and serum IL⁃6,CRP/Alb,IP⁃10 as independent risk factors for moderate to severe infections in patients with upper urinary tract stones.The re⁃ceiver operating characteristic curve results showed that the area under the curve(AUC)for u⁃rinary NGAL,and serum IL⁃6,CRP/Alb,IP⁃10,as well as the combined diagnosis for moder⁃ate to severe infections of upper urinary tract stones,were 0.872,0.828,0.904,0.717,and 0.989,respectively.Conclusion The clinical prediction model established in this study can effec

关 键 词：上尿路结石 感染 危险因素 预测模型 临床诊疗 

分 类 号：R691.3[医药卫生—泌尿科学]