输尿管结石术后泌尿系统感染患者的血清PCT、TLR4、CRP/ALB变化及预测价值  

Changes and predictive value of serum PCT,TLR4 and CRP/ALB in patients with urinary system infection after ureteral calculi surgery

作　　者：王荣 王彩军[1] 李强[1] Wang Rong;Wang Caijun;Li Qiang(Department of Urology,the Second Hospital of Qinhuangdao,Qinhuangdao 066600,China)

机构地区：[1]秦皇岛市第二医院泌尿外科,秦皇岛066600

出　　处：《国际泌尿系统杂志》2025年第1期22-26,共5页International Journal of Urology and Nephrology

基　　金：秦皇岛市科学技术研究与发展计划项目(201902A075)。

摘　　要：目的探究输尿管结石术后泌尿系统感染患者的血清降钙素原(PCT)、Toll样受体4(TLR4)、C反应蛋白/白蛋白比值(CRP/ALB)变化及预测价值。方法选取2021年2月至2022年12月本院收治的118例输尿管结石患者为研究对象,根据术后是否发生泌尿系统感染将患者分为感染组(32例)和非感染组(86例)。比较两组患者的血清PCT、TLR4、CRP/ALB水平,采用单因素及多因素logistic回归分析探究输尿管结石术后泌尿系统感染的影响因素,绘制受试者工作特征(ROC)曲线分析血清PCT、TLR4、CRP/ALB对术后泌尿系统感染的预测价值。结果感染组的血清PCT、TLR4及CRP/ALB值均高于非感染组(均P<0.05);两组患者的年龄、是否合并糖尿病、是否合并梗阻、手术时间、术后结石残留与否、尿管留置时间比较,差异均有统计学意义(均P<0.05);多因素logistic回归分析显示,合并糖尿病、合并梗阻、结石残留、尿管留置时间≥7 d、PCT、TLR4、CRP/ALB均是输尿管结石术后泌尿系统感染的危险因素(均P<0.05)。ROC曲线分析结果显示,血清PCT、TLR4、CRP/ALB及三者联合预测术后泌尿系统感染的ROC曲线下面积分别为0.928、0.835、0.892、0.982。结论输尿管结石术后泌尿系统感染患者的血清PCT、TLR4、CRP/ALB水平均明显升高,三者检测有助于预测术后泌尿系统感染,且联合检测预测效能更高。Objective To explore the changes and predictive value of serum procalcitonin(PCT),Toll-like receptor 4(TLR4)and C-reactive protein/albumin ratio(CRP/ALB)in patients with urinary system infection after ureteral calculi surgery.Methods From February 2021 to December 2022,118 patients with ureteral calculi were selected and divided into infected group(32 cases)and non-infected group(86 cases)according to whether urinary system infection occurred after surgery.Serum PCT,TLR4 and CRP/ALB levels were compared between the two groups.Univariate analysis and multivariate Logistic regression analysis were used to explore the influencing factors of urinary system infection after ureteral calculi surgery,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum PCT,TLR4 and CRP/ALB on postoperative urinary system infection.Results Serum PCT,TLR4 and CRP/ALB values in infected group were higher than those in non-infected group(all P<0.05).There were statistically significant differences in age,diabetes mellitus,obstruction,operation time,postoperative stone residue and urinary catheter retention time between the two groups(all P<0.05).Multivariate logistic regression analysis showed that combined diabetes,combined obstruction,stone residue,catheter retention time≥7 days,PCT,TLR4,CRP/ALB were all risk factors for urinary system infection after ureteral calculi surgery(all P<0.05).ROC curve analysis results showed that the area under ROC curve of serum PCT,TLR4,CRP/ALB and their combined prediction of postoperative urinary system infection were 0.928,0.835,0.892 and 0.982,respectively.Conclusions Serum levels of PCT,TLR4 and CRP/ALB in patients with urinary system infection after ureteral calculi surgery are significantly increased,and the three indicators are helpful to predict postoperative urinary system infection,and the combined detection has higher predictive efficiency.

关 键 词：输尿管结石 泌尿道感染 降钙素原 TOLL样受体4 

分 类 号：R699.4[医药卫生—泌尿科学]