下尿路结石合并感染患者尿路病原菌分布及其血清CA125、YKL-40水平变化  

Distribution of urinary tract pathogens and changes of serum CA125 and YKL-40 levels in patients with lower urinary tract calculi complicated with infection and its significance

作　　者：潘惠恩 苏雁峰 陈嘉敏 吴汝基 徐晓龙 PAN Huien;SU Yanfeng;CHEN Jiamin;WU Ruji;XU Xiaolong(Department of Urology,Songshan Lake Central Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]广东省东莞市松山湖中心医院泌尿外科,广东东莞523000

出　　处：《检验医学与临床》2025年第5期600-604,共5页Laboratory Medicine and Clinic

基　　金：广东省东莞市社会发展科技项目(20231800903902)。

摘　　要：目的探讨下尿路结石合并感染患者尿路病原菌分布及其血清糖类抗原125(CA125)、尿甲壳质酶蛋白-40(YKL-40)水平变化及意义。方法选取2022年1月至2024年1月该院接诊的100例下尿路结石合并感染患者作为病例组,另选取同期该院接诊的100例下尿路结石未合并感染患者作为对照组。分析病例组病原菌分布情况,采用全自动化学发光分析仪以酶联免疫吸附试验检测2组血清CA125、YKL-40水平;采用多因素Logistic回归分析下尿路结石合并感染的影响因素;采用受试者工作特征(ROC)曲线分析血清CA125、YKL-40对下尿路结石合并感染的诊断价值。结果病例组共分离出病原菌92株,其中革兰阴性菌占63.04%,革兰阳性菌占28.26%,真菌占8.70%。革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌以粪肠球菌、金黄色葡萄球菌为主;真菌有白色假丝酵母菌、热带假丝酵母菌。病例组合并糖尿病、结石最大径≥2 cm、尿路梗阻占比及血清YKL-40、CA125水平均高于对照组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清CA125、YKL-40、合并糖尿病、结石最大径、尿路梗阻是下尿路结石合并感染的影响因素(P<0.05)。ROC曲线分析结果显示,血清CA125、YKL-40单独及二者联合检测诊断下尿路结石合并感染的曲线下面积(AUC)分别为0.802、0.789、0.900,二者联合检测诊断下尿路结石合并感染的AUC均大于CA125、YKL-40单独检测的AUC,差异均有统计学意义(Z=3.559、4.175,P<0.05),其灵敏度、特异度分别为75.00%、87.00%。结论下尿路结石合并感染患者以革兰阴性菌为主,患者血清CA125、YKL-40水平均明显升高,CA125、YKL-40联合检测对下尿路结石合并感染具有更高的诊断价值。Objective To investigate the distribution of urinary tract pathogens and the changes of serum carbohydrate antigen 125(CA125)and urinary chitinase protein-40(YKL-40)levels in patients with lower urinary tract calculi complicated with infection and its significance.Methods A total of 100 patients with lower urinary tract calculi complicated with infection admitted to the hospital from January 2022 to January 2024 were selected as the case group,and 100 patients with lower urinary tract calculi without infection admitted to the hospital during the same period were selected as the control group.The distribution of pathogenic bacteria in the case group was analyzed,and the serum levels of CA125 and YKL-40 in the two groups were detected by automatic chemiluminescence analyzer and enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of lower urinary tract calculi complicated with infection.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum CA125 and YKL-40 for lower urinary tract calculi complicated with infection.Results A total of 92 strains of pathogenic bacteria were isolated in the case group,of which Gram-negative bacteria accounted for 63.04%,Gram-positive bacteria accounted for 28.26%,and fungi accounted for 8.70%.Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae.Gram-positive bacteria were mainly Enterococcus faecalis and Staphylococcus aureus.The fungi were Candida albicans and Candida tropicalis.The proportion of combined diabetes mellitus,maximum diameter of stones≥2 cm,urinary obstruction and serum YKL-40 and CA125 levels in the case group were higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that serum CA125,YKL-40,combined diabetes,maximum stone diameter,and urinary tract obstruction were the influencing factors of lower urinary tract calculi complicated with infection(P<0.0

关 键 词：下尿路结石 感染 病原菌 糖类抗原125 尿甲壳质酶蛋白-40 

分 类 号：R695[医药卫生—泌尿科学] R446.5[医药卫生—外科学]