三种微创术式对输尿管结石患者血清sCD166、CRP及sICAM-5水平的影响  

Effects of three minimally invasive surgical procedures on serum sCD166,CRP and sI-CAM-5 levels in patients with ureteral calculi

作　　者：富雅洁 罗丽坤 于静轩 许姗姗[4] 凯赛尔·阿吉[1] FU Yajie;LUO Likun;YU Jingxuan;XU Shanshan;KAISAIER·Aji(Department of Urology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China,830054;Operation Room,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China,830054;Department of Outpatient Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China,830054;Outpatient Department of Emergency and Trauma Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,China,830054)

机构地区：[1]新疆医科大学第一附属医院泌尿外科,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院手术室,新疆乌鲁木齐830054 [3]新疆医科大学第一附属医院门诊外科,新疆乌鲁木齐830054 [4]新疆医科大学第一附属医院急救·创伤中心门诊,新疆乌鲁木齐830054

出　　处：《分子诊断与治疗杂志》2025年第2期259-262,共4页Journal of Molecular Diagnostics and Therapy

基　　金：新疆维吾尔自治区自然科学基金(2023D01C107)。

摘　　要：目的评估三种微创术式对输尿管结石患者血清可溶性白细胞分化抗原166(sCD166),C-反应蛋白(CRP)及可溶性细胞间黏附分子-5(sICAM-5)水平的影响。方法回顾性分析2020年1月至2023年3月新疆医科大学第一附属医院收治的101例输尿管结石患者,并根据治疗方法分为A组33例[经尿道输尿管镜碎石取石术(URL)]、B组34例[微通道经皮肾穿刺碎石取石术(MPCNL)]、C组34例[后腹腔镜输尿管切开取石术(RLU)]。比较三组手术相关指标、血清指标(sCD166、CRP及sICAM-5)、疼痛程度、应激激素水平及并发症发生率。结果手术时间、住院时间比较:A组<B组<C组,术中出血量比较:A组<C组<B组,差异有统计学意义(P<0.05)。三组术后血清sCD166、CRP及sICAM-5、SOD水平均下降,Cor、MDA水平均上升,且sCD166、CRP及sICAM-5水平:B组<C组<A组,SOD水平:A组>C组>B组,Cor、MDA水平:A组<C组<B组,差异有统计学意义(P<0.05)。三组术后6 h、12 h、24 h、48 h VAS评分均降低,术后6 h、12 h、24 h、48 h VAS评分:A组<C组<B组,差异有统计学意义(P<0.05)。三组总并发症发生率比较,差异无统计学意义(P>0.05)。结论URL、MPCNL、RLU均可用于治疗输尿管结石,其中MPCNL和RLU结石清除率高但术后疼痛应激重且对血清sCD166、CRP及sICAM-5指标影响较大,URL术式对这些血清指标影响较小但结石清除率相对低。Objective To evaluate the effects of three minimally invasive procedures on serum levels of sCD166,CRP and sICAM-5 in patients with ureteral calculi.Methods A retrospective analysis was performed on 101 patients with ureteral calculi admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2020 to March 2023.Based on the treatment methods,the patients were divided into group A(33 cases)[transethral ureteroscopic lithotripsis(URL)],group B(34 cases)[micro-channel percutaneous nephrolithotripsis(MPCNL)]and group C(34 cases)[retroperitoneal laparoscopic ureterolithotomy(RLU)].The operation related indexes,serum indicators(sCD166,CRP and sICAM-5),pain levels,stress hormone levels and complication rates of the three groups were compared.Results Comparison of operation time and hospital stay among the three groups:Group A<Group B<group C;comparison of intraoperative blood loss:group A<group C<group B(P<0.05).The levels of serum sCD166,CRP,sICAM-5,and SOD in the three groups decreased after operation,while the levels of Cor and MDA increased,and the levels of sCD166,CRP,and sICAM-5:Group B<Group C<group A,SOD level:Group A>Group C>Group B,Cor and MDA levels:Group A<group C<group B(P<0.05).The VAS scores at 6 h,12 h,24 h and 48 h post-operation were lower in all three groups compared to baseline,Additionally,the VAS scores og group A were lower than group B and C at each time points(P<0.05).There was no significant difference in the incidence of total complications among the three groups(P>0.05).Conclusion Ureteroscopic URL,MPCNL,and RLU can be used to treat ureteral calculi.MPCNL and RLU have a high stone clearance rate,but they also result in severe postoperative pain and stress,which can greatly influence serum sCD166,CRP,and sICAM-5 indicators.URL,on the other hand,has little effect on these serum indicators,but the stone clearance rate is relatively low.

关 键 词：输尿管结石 sCD166 CRP sICAM-5 

分 类 号：R699.4[医药卫生—泌尿科学]