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作 者:王二庆[1] 周骏[2] 杨发武 刘刚[1] 郝宗耀[2] Wang Erqing;Zhou Jun;Yang Fawu;Liu Gang;Hao Zongyao(Department of Urology,Suixi County Hospital of Anhui Province,Huaibei 235100,China;Department of Urology,the First Affilated Hospital of Anhui Medical University,Hefei 230022,China)
机构地区:[1]安徽省濉溪县医院泌尿外科,淮北235100 [2]安徽医科大学第一附属医院泌尿外科,合肥230022
出 处:《国际泌尿系统杂志》2025年第1期40-43,共4页International Journal of Urology and Nephrology
基 金:国家自然科学基金(82070724);安徽医科大学第一附属医院临床研究启动计划重点项目(LCYJ2021ZD001)。
摘 要:目的探讨经皮肾镜取石术(PCNL)术前不同炎症指标对术后全身炎症反应综合征(SIRS)的预测价值。方法回顾性分析2017年1月至2021年3月在濉溪县医院接受PCNL治疗的142例泌尿系结石患者的临床资料。按PCNL术后是否发生SIRS将患者分为SIRS组(34例)和非SIRS组(108例)。比较两组患者的临床资料。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析各指标对患者发生SIRS的预测效能。结果SIRS组患者的术前降钙素原(PCT)、C反应蛋白(CRP)、术前中性粒细胞、肾积水中重度和术前尿培养阳性比例显著高于非SIRS组,差异均有统计学意义(均P<0.05)。ROC曲线分析结果显示,与中性粒细胞和CRP比较,PCT具有更高的预测诊断效能,三者联合的诊断效能与PCT联合CRP的差异不明显,但优于单一标志物。结论术前中性粒细胞计数、PCT及CRP均能用于预测患者PCNL术后感染,PCT联合CRP对PCNL术后发生SIRS具有优异的预测价值,值得临床推广应用。Objective To investigate the predictive value of different inflammatory indexes before percutaneous nephrolithotomy(PCNL)in postoperative systemic reactive inflammatory syndrome(SIRS).Methods The clinical data of 142 patients with urinary calculi treated with PCNL in Suixi County Hospital from January 2017 to March 2021 were retrospectively analyzed.According to the occurrence of SIRS after PCNL,the patients were divided into SIRS group(34 cases)and non-SIRS group(108 cases).The clinical data of the two groups were compared.Receiver operating characteristic(ROC)curve was plotted,area under the curve(AUC)was calculated,and the predictive efficacy of each indicator for SIRS was analyzed.Results The preoperative positive proportions of procalcitonin(PCT),C-reactive protein(CRP),neutrophils,moderate to severe hydronephrosis,and urine culture were significantly higher in the SIRS group compared to the non-SIRS group,with statistical significance(all P<0.05).ROC curve analysis demonstrated that PCT exhibited superior predictive diagnostic efficacy when compared to neutrophils and CRP.The combination of PCT and CRP showed similar diagnostic efficacy but was superior to using a single marker.Conclusions Preoperative neutrophil count,PCT and CRP can be used to predict postoperative infection in patients undergoing PCNL.PCT combined with CRP has excellent predictive value for the occurrence of SIRS after PCNL surgery,which is worthy of clinical promotion and application.
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