摘要
目的:评价血清降钙素原(PCT)水平在预测经皮肾镜(PNL)患者组间尿培养结果及术后细菌感染所致高热的检验效能。方法:回顾性分析自2015年1月-2018年1月于我院行PNL并符合研究标准的患者病例资料共358份,根据患者是否存在术后体温超过39℃分为对照组和高热组,收集患者性别,年龄,糖尿病史,高血压史,结石大小、数量,肾积水程度,患者术后2 h白细胞(WBC)、C-反应蛋白(CRP)、PCT、白介素-6(IL-6)、肌酐、尿白细胞,术前术后尿培养等指标,进行单因素分析及Logistic多因素回归分析,ROC曲线计算PCT预测组间尿培养结果及PCT预测术后高热的曲线下面积(AUC),并确定其阈值。结果:结合单因素分析及Logistic多因素回归分析显示PCT(P<0.001),尿培养(P=0.045),结石大小(P=0.012)为PNL术后高热的独立危险因素,ROC曲线结果显示对照组的AUC为0.693,阈值为0.049 5 ng/mL,高热组的AUC为0.828,阈值为0.14 ng/mL,PCT预测术后高热的AUC为0.737,阈值为0.072 5 ng/mL。结论:血清PCT水平能有效预测术后细菌感染所致高热并与高热组中的尿培养结果具有良好的相关性。
Objective： To evaluate the value of serum levels of procalcitonin（PCT） in predicting the results of urine cultures in groups of patients and infectious fever following percutaneous nephrolithotomy （PNL）. Methods： We retrospectively reviewed the medical records of 358 patients who underwent PNL and met the inclusion criteria in our institution from January 2015 to January 2018. Patients＇ demographic and perioperative data such as age, sex, history of diabetes mellitus, hypertension and stone burden were collected, white blood cell, C-reactive protein, PCT, interleukin-6, creatinine and urine leukocytes were detected 2 hours after PNL, and urine cultures was detected before and after PNL. Patients were stratified into the control and high fever group based on body temperature either lower than or higher than 39℃. Univariate analysis, binary logistic regression analysis and ROC curves were used to evaluate the value of PCT in predicting the results of urine cultures between groups and infectious fever following PNL. Results： PCT levels （P〈0.001）, urine culture （P=0.045） and stone burden （P=0.012） were found independent risk factors for infectious fever following PNL. The ROC curves revealed that the cutoff point of PCT for predicting positive urine culture in control group was 0.049 5 ng/mL with the AUC of 0.693, while in high fever group the cutoff point was 0.14 ng/mL and the AUC is 0.828. And we also found the cutoff point of PCT for predicting infectious fever was 0.072 5 ng/mL with the AUC of 0.737 ng/mL. Conclusion： Serum level of PCT may be an effective predictor for predicting infectious fever following PNL and is closely related to the results of urine cultue in high fever group.
作者
费夏俊
林毅
FEI Xia-jun;LIN-Yi(Department of Urology,General Hospital,Tianjin Medical University,Tianjin 300052,China)
出处
《天津医科大学学报》
2018年第6期524-528,535,共6页
Journal of Tianjin Medical University
关键词
降钙素原
经皮肾镜
术后发热
尿培养
Procalcitonin
percutaneous nephrolithotomy
postoperative fever
urine culture
