摘要
目的探究前列腺增生术后血清半胱氨酸天冬氨酸蛋白酶9(cysteine-dependent aspartate-specifc proteases-9,Caspase-9)、总前列腺特异性抗原(total prostate-specific antigen,tPSA)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)水平监测在尿路感染预警中的意义。方法选取2020年8月—2023年2月河南省职工医院102例前列腺增生手术患者,根据患者术后是否发生尿路感染分为感染组(15例)与未感染组(87例)。比较2组患者基线资料及手术前后血清Caspase-9、tPSA、MCP-1水平,分析前列腺增生术后尿路感染影响因素;并评价术后血清Caspase-9、tPSA、MCP1对前列腺增生术后尿路感染的预测价值。结果2组术后第1、3、5天血清Caspase-9、tPSA、MCP-1水平均较术前明显升高,且感染组升高程度较未感染组更为显著(P<0.05);多因素logistic回归分析结果显示,术后第5天血清Caspase-9、tPSA、MCP-1均为前列腺增生术后尿路感染的独立危险因素(P<0.05);绘制术后第1、3、5天血清Caspase-9、tPSA、MCP-1预测前列腺增生术后尿路感染的受试者工作特征(receiver operating charac-teristic,ROC)曲线,术后第5天血清Caspase-9、tPSA、MCP-1的曲线下面积(area under the curve,AUC)值>术后第3天>术后第1天(P<0.05);进一步分析显示,术后第1、3、5天血清Caspase-9、tPSA、MCP-1联合预测AUC分别为0.885、0.906、0.934,明显较各时间点单个指标大,且术后第5天血清Caspase-9、tPSA、MCP-1联合预测的AUC>术后第3天>术后第1天(P<0.05)。结论前列腺增生术后尿路感染患者血清Caspase-9、tPSA、MCP-1水平明显升高,术后监测血清Caspase-9、tPSA、MCP-1水平变化,在术后尿路感染预警中具有积极意义。
Objective To investigate the significance of monitoring serum cysteine-dependent aspartate-specifc proteases-9(Caspase-9),total prostate-specific antigen(tPSA),and monocyte chemotactic protein-1(MCP-1)levels in the early warning of urinary tract infection after surgery for prostatic hyperplasia.Methods One hundred and two patients undergoing surgery for prostatic hyperplasia in Henan General Hospital from August 2020 to February 2023 were selected and divided into infected group(n=15)and uninfected group(n=87)according to whether the patients had urinary tract infection after surgery.The baseline data,pre-and post-surgical serum Caspase-9,tPSA,and MCP-1 levels were compared between the two groups,the factors affecting postoperative urinary tract infections were analyzed,and the predictive values of postoperative serum Caspase-9,tPSA,and MCP-1 for postoperative urinary tract infections were evaluated.Results The levels of serum Caspase-9,tPSA and MCP-1 were significantly higher on the first,third and fifth postoperative days in both groups compared with those before surgery,and the degree of increase was more significant in the infected group than in the non-infected group(P<0.05).Multifactorial logistic regression analysis showed that serum Caspase-9,tPSA,and MCP-1 on postoperative day 5 were independent risk factors in postoperative urinary tract infection(P<0.05).Receiver operating charac-teristic(ROC)curves of serum Caspase-9,tPSA,and MCP-1 on postoperative days 1,3,and 5 were plotted to predict postoperative urinary tract infection,and the area under the curve(AUC)values of serum Caspase-9,tPSA,and MCP-1 on postoperative day 5>postoperative day 3>postoperative day 1(P<0.05).Further analysis showed that AUC of the combined prediction of serum Caspase-9,tPSA,and MCP-1 on postoperative days 1,3,and 5 were 0.885,0.906,and 0.934,respectively,which were significantly larger than those of the individual indicator at each time point.AUC of the combined prediction of serum Caspase-9,tPSA,and MCP-1 on postoperative day 5>postoperative day 3>postoperative day 1(P<0.05).Conclusion Serum Caspase-9,tPSA,and MCP-1 levels significantly elevate in patients with postoperative urinary tract infection after surgery for prostatic hyperplasia,so postoperative monitoring of changes in serum Caspase-9,tPSA,and MCP-1 levels is of positive significance in early warning of postoperative urinary tract infection.
作者
王峰岩
苏孟珂
钱锦
王晓辉
WANG Fengyan;SU Mengke;QIAN Jin;WANG Xiaohui(Department of Urology,Henan General Hospital,Zhengzhou,450003,China;Department of Urology,Zhengzhou Central Hospital)
出处
《临床泌尿外科杂志》
CAS
2024年第9期823-828,共6页
Journal of Clinical Urology
关键词
前列腺增生
经尿道前列腺电切术
尿路感染
半胱氨酸天冬氨酸蛋白酶9
总前列腺特异性抗原
单核细胞趋化蛋白-1
prostatic hyperplasia
transurethral resection of prostate
urinary tract infection
cysteine-dependent aspartate-specifc proteases-9
total prostate-specific antigen
monocyte chemotactic protein-1
