Risk factors for postoperative urogenic sepsis in patients undergoing ureteroscopy with holmium laser lithotripsy and changes of TLR4/NF-κB signaling pathways
OBJECTIVE To explore the risk factors for postoperative urogenic sepsis(US)in the patients undergo-ing ureteroscopy with holmium laser lithotripsy(F-URS)and observe the activation state of Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)pathways.METHODS A total of 197 patients who underwent F-URS in Ganzi People's Hospital from Jan 2018 to Jan 2023 were recruited as the research subjects and were divid-ed into the US group with 51 cases and the non-US group with 146 cases according to the status of US after R-URS.Multivariate logistic analysis was performed for the risk factors for the postoperative US in the F-URS pa-tients.The values of TLR4 and NF-κB in diagnosis of postoperative US were analyzed by means of receiver oper-ating characteristic(ROC)curves.RESULTS The incidence of US was 25.89％after F-URS.The result of multi-variate logistic regression analysis showed that the no less than 60 years of age,operation duration no less than 1 hour,history of urinary tract surgery,high level of WBC and low level of PLT were the risk factors for the post-operative US in the F-URS patients(P＜0.05).The levels of serum TLR4 and NF-κB of the US group were high-er than those of the non-US group(P＜0.05).The area under curve(AUC)of the joint detection of TLR4 and NF-κB was 0.889 in diagnosis of US,with the sensitivity 80.40％,the specificity 82.20％.CONCLUSION The incidence of postoperative US is high among the F-URS patients and is associated with the age,operation dura-tion,history of urinary tract surgery,WBC level and PLT level.The TLR4/NF-κB signaling pathways of the F-URS patients with postoperative US are activated.The joint detection of TLR4 and NF-κB may facilitate the diag-nosis of postoperative US in the F-URS patients.
Ureteroscopy with holmium laser lithotripsyUrogenic sepsisRisk factorToll-like receptor 4Nu-clear transcription factor-κBDiagnostic value
NETL
NSTL
万方数据
维普
