Predictive value of calculi CT value combined with IPS and Toll-like receptor for urinary sepsis after PCNL
Objective To investigate the value of calculi CT value,infection possibility score(IPS),and Toll-like receptor(TLR)mRNA level of peripheral blood mononuclear cells in predicting urinary sepsis after percutaneous nephrolithotomy(PCNL).Methods Forty-three patients with urinary sepsis after PCNL were selected as sepsis group,while 105 patients without sepsis after PCNL were selected as control group according to propensity score.The postoperative calculi CT value,IPS and TLR mRNA level of peripheral blood mononuclear cells were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to analyze the value of each index in predicting urinary sepsis after PCNL.Results The calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA levels in sepsis group were significantly higher than those in control group(P<0.05).Compared with control group,sepsis group had higher proportion of stone diameter≥2.0 cm,proportion of staghorn stone,postoperative ratio of neutrophil to lymphocyte and postoperative procalcitonin,but lower postoperative albumin,with statistical differences(P<0.05).The area under ROC curve of calculi CT value,IPS,TLR2 mRNA,TLR4 mRNA and the combination of the 4 indexes to predict urinary sepsis after PCNL were 0.669,0.794,0.710,0.584 and 0.907,respectively.Conclusion The increases of calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA after PCNL are associated with urinary sepsis.A comprehensive consideration of these 4 indicators is of high value for predicting urinary sepsis in clinic.
万方数据
维普
