摘要
目的 探究C-反应蛋白(CRP)和降钙素原(PCT)在经皮肾镜取石术(PCNL)后并发尿源性脓毒血症早期诊断中的价值,为临床早期诊断及治疗尿源性脓毒症提供参考依据。方法 回顾性分析2017年1月-2020年2月在中国人民解放军联勤保障部队第九四○医院行PCNL的119例患者(分为对照组和病例组)的临床数据,通过比较2组患者术前、术后血清CRP及PCT水平,绘制单项指标及两者联合检测的受试者工作特征曲线(ROC),评价其对尿源性脓毒血症的诊断价值。结果 术前2组患者CRP和PCT水平差异均无统计学意义(P> 0.05);与术前比较,术后2组患者CRP及PCT水平均上升(P <0.01);血清CRP诊断PCNL后尿脓毒血症的ROC下面积(AUC)略低于PCT;CRP和PCT单独检测的AUC明显低于两者联合检测的。结论 CRP及PCT均可作为PCNL术后并发尿源性脓毒血症早期诊断的可靠指标,PCT比CRP更有诊断价值,并且CRP及PCT联合检测可提高诊断效能。
Objective To explore the value of C-reactive protein(CRP) and procalcitonin(PCT) in the early diagnosis of urosepsis after percutaneous nephrolithotomy(PCNL). To provide reference for early clinical diagnosis and treatment of urinary pyemia. Methods The clinical data of 119 patients who underwent PCNL in The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army from January 2017 to February 2020 were retrospectively analyzed(devided in the control group and the case group). The serum CRP and PCT levels were compared between the two groups before and after surgery, and the receiver operating characteristic curve(ROC) of the single index and the combined indexes detection was drawn to evaluate their diagnostic value for urosepsis. Results There was no significant difference in the levels of CRP and PCT between the two groups before surgery(P > 0.05). Compared with preoperative, the levels of CRP and PCT in the two groups increased after surgery(P < 0.01). The area under the ROC curve(AUC) of serum CRP for the diagnosis of urosepsis after PCNL was slightly lower than that of PCT. The AUC of CRP and PCT alone detection was significantly lower than that of the combined detection. Conclusion Both CRP and PCT can be used as reliable indicators for the early diagnosis of urinary pyemia after PCNL. PCT has more diagnostic value than CRP, and the combined detection of CRP and PCT can improve the diagnostic efficiency.
作者
张伟君
张春雷
常德辉
康印东
Zhang Wei-jun;Zhang Chun-lei;Chang De-hui;Kang Yin-dong(Department of Urology,The 940th Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China)
出处
《兰州大学学报（医学版）》
2022年第6期69-72,共4页
Journal of Lanzhou University（Medical Sciences）
基金
甘肃省卫生健康行业科研基金资助项目(GSWSKY2020-71)
中国人民解放军联勤保障部队第九四○医院专项培育基金资助项目(2021yxky041)。
