摘要
目的分析血浆胶原凝集素-11(CL-11)对复杂性上尿路感染导致尿脓毒症的预测作用。方法回顾性分析2016年1月-2020年12月南宁市红十字会医院86例行经皮肾镜碎石取石术(PCNL)的上尿路感染患者临床资料,根据继发尿脓毒症情况分为尿脓毒症组41例及非尿脓毒症45例。记录两组基线资料及病原菌情况,比较两组术前2 h及术后2 h血清CL-11、降钙素原(PCT)差异,使用受试者工作特征(ROC)曲线评估术前血清CL-11、PCT对术后尿脓毒症的预测价值;记录尿脓毒症组预后转归情况,将继发感染性休克及(或)死亡者纳入预后不良组,其他纳入预后良好组,分析不同预后转归者血清CL-11、PCT差异。结果尿脓毒症组女性、术前尿路感染、糖尿病占比高于非尿脓毒症组(P<0.05);两组术中肾盂尿均以大肠埃希菌等革兰阴性菌居多;两组术后2 h血清CL-11、PCT均较术前2 h升高(P<0.05),且尿脓毒症组手术前后血清CL-11、PCT均高于非尿脓毒症组(P<0.05);ROC曲线分析显示,术前血清CL-11、PCT对术后尿脓毒症具有较高预测价值[曲线下面积(AUC)=0.927、0.828,P<0.001],其截断值分别为254.19 ng/ml、2.37 ng/ml,且2项联合预测价值更高(AUC=0.954,P<0.001);尿脓毒症患者中,预后不良组手术前后血清CL-11、PCT均高于预后良好组(P<0.05)。结论血清CL-11、PCT对预测复杂性上尿路感染继发尿脓毒症有利,且能辅助评估患者预后转归情况。
OBJECTIVE To analyze the predictive effect of plasma collectin-11(CL-11)on urosepsis caused by complicated upper urinary tract infection.METHODS The clinical data of 86 patients with upper urinary tract infection who underwent percutaneous nephrolithotomy(PCNL)in Nanning Red Cross Hospital from Jan.2016 to Dec.2020 were retrospectively analyzed.According to the secondary urosepsis,the patients were divided into 41 cases of urosepsis group and 45 cases of non-urosepsis group.The baseline data and pathogenic bacteria in the two groups were recorded,and the differences in levels of serum CL-11 and procalcitonin(PCT)at 2 h before surgery and at 2 h after surgery were compared between the two groups,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of preoperative serum CL-11 and PCT for postoperative urosepsis.The prognosis and outcomes of urosepsis group were recorded,and the patients with secondary septic shock and/or death were included in the poor prognosis group,and the others were included in the good prognosis group.The differences in serum CL-11 and PCT among patients with different prognosis outcomes were analyzed.RESULTS The proportion of patients with female gender,preoperative urinary tract infection and diabetes mellitus in urosepsis group were higher than those in the non-urosepsis group(P<0.05).Gram-negative bacteria such as Escherichia coli were the majority in the renal pelvis urine in the two groups during surgery.The levels of serum CL-11 and PCT at 2 h after surgery in the two groups were significantly higher than those at 2 h before surgery(P<0.05),and the levels of serum CL-11 and PCT in urosepsis group before and after surgery were higher than those in non-urosepsis group(P<0.05).ROC curve analysis showed that preoperative serum CL-11 and PCT had high predictive value for postoperative urosepsis(AUC=0.927 and 0.828,respectively,P<0.001),and the cutoff values were 254.19 ng/ml and 2.37 ng/ml,respectively,and the predictive value of the combination of t
作者
甘伟胜
零云
陈武强
肖艺
陈俭
GAN Wei-sheng;LING Yun;CHEN Wu-qiang;XIAO Yi;CHEN Jian(Nanning Red Cross Hospital,Nanning,Guangxi 530012,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第20期3093-3097,共5页
Chinese Journal of Nosocomiology
基金
广西壮族自治区科研基金资助项目(2020G017)。
