摘要
目的 分析血清β-防御素-3(HBD-3)、诱骗受体3(DCR3)对复杂性肾结石患者经皮肾镜碎石术后尿路感染的预测价值.方法 选取2020年1月-2022年12月河北省沧州中西医结合医院收治的112例复杂性肾结石患者为研究对象进行回顾性研究,所有患者均行经皮肾镜碎石术(PCNL),根据术后感染情况将患者分为非尿路感染组52例、尿路感染组60例.比较两组一般资料及HBD-3、DCR3水平.受试者工作特征(ROC)曲线分析C反应蛋白(CRP)、降钙素原(PCT)、HBD-3、DCR3水平对术后尿路感染的预测价值.结果 与非尿路感染组比较,尿路感染组的HBD-3[(0.77±0.08)ng/mL vs.(1.36±0.25)ng/mL,P=0.001]、DCR3[(4.68±0.53)ng/mL vs.(13.21±0.28)ng/mL,P=0.001]水平较高.多因素 logistics 回归分析显示,泌尿道手术史、术前尿路感染、手术时间、导尿管留置时间、结石负荷、抗菌药物种类、合并肾功能障碍、术中通道类型CRP、PCT、HBD-3、DCR3为患者术后尿路感染的影响因素(P＜0.05).ROC曲线显示,CRP、PCT、CRP联合PCT准确度分别为70.54％、72.32％、78.57％;HBD-3、DCR3、HBD-3联合DCR3准确度分别为69.64％、75.89％、86.61％.结论 复杂性肾结石患者术后尿路感染与多种因素相关,且术后尿路感染患者HBD-3、DCR3表达水平较高,联合检测对术后尿路感染具有较高的预测价值.
Abstract
Objective To analyze the predictive value of serum β-defensin-3(HBD-3)and decoy receptor 3(DCR3)for urinary tract infection after percutaneous nephrolithotomy(PCNL)in patients with complex kidney calculi.Methods A prospective study was conducted on 112 patients treated with PCNL at our hospital during Jan.2020 and Dec.2022.The patients were divided into the non-infection group(52 cases)and infection group(60 cases).The general data,HBD-3 and DCR3 levels of the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of C reactive protein(CRP),procalcitonin(PCT),HBD-3 and DCR3 levels for postoperative urinary tract infection.Results Compared with the non-infection group,the infection group had higher levels of HBD-3[(0.77±0.08)ng/mL vs.(1.36± 0.25)ng/mL,P=0.001]and DCR3[(4.68±0.53)ng/mL vs.(13.21±0.28)ng/mL,P=0.001].Multivariate logistic regression showed that a history of urinary tract surgery,preoperative urinary tract infection,operation time,catheterization time,stone load,type of antibiotics,concomitant renal dysfunction,intraoperative channel type,CRP,PCT,HBD-3 and DCR3 were risk factors of postoperative urinary tract infection(P＜0.05).The ROC curve showed that the accuracy of CRP,PCT,and CRP plus PCT were 70.54％,72.32％,and 78.57％,respectively;the accuracy of HBD-3,DCR3,and HBD-3 plus DCR3 were 69.64％,75.89％,and 86.61％,respectively.Conclusion Postoperative urinary tract infection in patients with complex kidney calculi is associated with multiple factors,especially high expression levels of HBD-3 and DCR3.Combined detection has high predictive value.
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