摘要
【目的】探讨肝素结合蛋白(HBP)、可溶性CD14亚型(sCD14-ST)与感染可能性(IPS)评分对经皮肾镜取石术(PCNL)术后发生尿源性脓毒血症的预测价值。【方法】选取2018年1月至2021年1月本院收治的44例PCNL术后发生尿源性脓毒血症患者(观察组),另选取本院同期收治的44例PCNL术后无尿源性脓毒血症患者(对照组)。比较两组临床资料、尿HBP、血清sCD14-ST水平及IPS评分,分析尿HBP、血清sCD14-ST水平与IPS评分的相关性及PCNL术后发生尿源性脓毒血症的影响因素,评估各指标对PCNL术后发生尿源性脓毒血症的预测价值。【结果】观察组术前尿培养阳性比例高于对照组,手术时间长于对照组,尿HBP、血清sCD14-ST水平及IPS评分高于对照组(P<0.05)。Pearson相关性分析显示,尿HBP、血清sCD14-ST水平与IPS评分均呈正相关(r=0.608、0.534,P<0.05)。Logistic回归分析显示,术前尿培养阳性、手术时间、尿HBP、血清sCD14-ST、IPS评分是PCNL术所致尿源性脓毒血症的影响因素(P<0.05)。尿HBP、血清sCD14-ST、IPS评分联合预测PCNL术后尿源性脓毒血症的曲线下面积(AUC)为0.909,95%CI为0.828~0.960,敏感度为95.45%,特异度为75.00%,明显高于三者单独预测。【结论】尿HBP、血清sCD14-ST、IPS评分是PCNL术后发生尿源性脓毒血症的影响因素,联合检测可作为预测尿源性脓毒血症发生的重要方法。
【Objective】To investigate the predictive value of heparin binding protein(HBP),soluble CD14 subtype(sCD14-ST)and infection probability(IPS)scores on urinary sepsis after percutaneous nephrolithotomy(PCNL).【Methods】From January 2018 to January 2021,44 patients with urinary sepsis after PCNL were selected as the observation group,and 44 patients without urinary sepsis after PCNL were selected as the control group.The clinical data,urinary HBP,serum sCD14-ST levels and IPS scores of the two groups were compared.The correlation between urinary HBP,serum sCD14-ST levels and IPS scores was analyzed.The influencing factors of urinary sepsis after PCNL were analyzed.The predictive value of each index for urinary sepsis after PCNL was evaluated.【Results】The positive rate of urine culture before operation in the observation group was higher than that in the control group,the operation time was longer than that in the control group,and the urine HBP,serum sCD14-ST levels and IPS scores were higher than those in the control group(P<0.05).Pearson correlation analysis showed that urine HBP,serum sCD14-ST levels were positively correlated with IPS scores(r=0.608,0.534,P<0.05).Logistic regression analysis showed that positive urine culture before operation,operation time,urine HBP,serum sCD14-ST,IPS score were the influencing factors of urinary sepsis caused by PCNL(P<0.05).The AUC of urine HBP,serum sCD14-ST and IPS scores for predicting urinary sepsis after PCNL was 0.909,95%CI was 0.828~0.960,sensitivity was 95.45%,specificity was 75.00%,which was significantly higher than those predicted by the three alone.【Conclusion】Urine HBP,serum sCD14-ST and IPS scores are the influencing factors of urinary sepsis after PCNL.The combined detection can be used as an important method to predict the occurrence of urinary sepsis.
作者
张晓荣
李微
ZHANG Xiao-rong;LI Wei(The First Hospital of Yulin,Yulin Shaanxi 719000)
出处
《医学临床研究》
CAS
2022年第9期1345-1348,共4页
Journal of Clinical Research
