摘要
目的 探讨输尿管结石术后尿源性脓毒症(US)患者外周血白细胞介素17A(IL-17A)、降钙素原与白蛋白比值(PAR)、系统免疫炎症指数(SII)中的表达情况及预测价值。方法 选取2022年6月至2024年9月于淮安市第一人民医院泌尿外科行输尿管软镜碎石术治疗的253例输尿管结石患者,根据术后是否发生US分为US组(n=42)及非US组(n=211)。比较2组患者临床资料、IL-17A、PAR和SII的差异;评估L-17A、PAR和SII水平对输尿管结石术后US的预测价值。结果 与非US组相比,US组患者术前尿路感染及输尿管手术史占比、IL-17A、PAR和SII水平较高,手术时间较长,差异有统计学意义(P<0.05);多因素结果显示,手术时间长、术前尿路感染、有输尿管手术史、IL-17A、PAR和SII水平高是输尿管结石患者术后发生US的独立影响因素,差异有统计学意义(P<0.05);IL-17A、PAR和SII单独及联合预测输尿管结石患者术后发生US的受试者工作曲线下面积分别为0.829、0.833、0.759、0.918,差异有统计学意义(P<0.05)。结论 外周血IL-17A、PAR和SII在输尿管结石术后US患者中呈高表达,且联合预测US的发生具有较高的价值。
Objective To investigate the expression and predictive value of interleukin 17A(IL⁃17A),procalcitonin to albumin ratio(PAR)and systemic immunoinflammatory index(SII)in peripheral blood of ureteral calculus patients with urosepsis(US).Methods A total of 253 patients with ureteral calculi who un⁃derwent ureteral soft lithotripry at the Department of Urology,Huaian First People's Hospital from June 2022 to September 2024 were selected.They were then divided into two groups:the US group(n=42)and the non⁃US group(n=211)based on the occurrence of ureteral stricture(US)after surgery.The clinical data,IL⁃17A,PAR levels,and SII were compared between the two groups to evaluate the predictive value of IL⁃17A,PAR,and SII levels for the development of US after ureteral calculi surgery.Results Compared to the non⁃US group,the US group had higher levels of preoperative urinary tract infection,ureteral operation history,IL⁃17A,PAR,and SII,as well as a longer operation time,all with statistical significance(P<0.05).Multi⁃factor analysis revealed that long operation time,preoperative urinary tract infection,history of ureteral operation,and high levels of IL⁃17A,PAR,and SII were independent influencing factors for postoperative US in patients with ureteral calculi,and the differences were statistically significant(P<0.05).IL⁃17A,PAR,and SII,either alone or in combination,were predictive of postoperative US incidence in patients with ureteral calculi,with area under the working curve values of 0.829,0.833,0.759 and 0.918,respectively,all statistically significant(P<0.05).Conclusion Peripheral blood IL⁃17A,PAR,and SII are highly expressed in US patients after ure⁃teral calculi surgery.They have high predictive value for the occurrence of US when combined.
作者
陈嘉敏
徐江浩
王云炎
CHEN Jiamin;XU Jianghao;WANG Yunyan(Department of Urology,the First People's Hospital of Huai'an City,Jiangsu Province,Huai'an,Jiangsu,China,223300)
出处
《分子诊断与治疗杂志》
2025年第6期1106-1108,1112,共4页
Journal of Molecular Diagnostics and Therapy
基金
淮安市科技项目(HAB2024013)。
