硕通镜联合超微通道经皮肾镜碎石取石术患者sCD14、RBP、IL-27水平与尿源性脓毒血症关系探讨

Study the relationship between the level of sCD14,RBP,IL-27 levels and urosepsis in patients underwent Shuotong mirror combined with super-mini percutaneous nephrolithotomy

目的:探究硕通镜联合超微通道经皮肾镜碎石取石术(SMP)患者可溶性白细胞分化抗原14(sCD14)、视黄醇结合蛋白(RBP)、白细胞介素-27(IL-27)水平变化与尿源性脓毒血症的关系。方法:回顾性分析2015年5月至2021年6月我院硕通镜联合SMP患者102例,其中发生尿源性脓毒血症患者51例(观察组),未发生尿源性脓毒血症患者51例(对照组)。比较两组临床资料、手术前后sCD14、RBP、IL-27水平,受试者工作特征(ROC)曲线评价术后sCD14、RBP、IL-27水平对尿源性脓毒血症的诊断价值。结果:观察组相比对照组术后sCD14[(537.89±150.69)pg/mlvs.(354.89±112.41)pg/ml]、RBP[(65.42±8.40)ng/L vs.(44.29±5.27)ng/L]、IL-27[(3.32±0.78)vs.(2.37±0.69)ng/ml]水平高,差异具有统计学意义(P<0.05);ROC曲线显示术后sCD14、RBP、IL-27水平诊断尿源性脓毒血症的AUC分别为0.828、0.901、0.857,多因素Logistic回归分析结果显示术后sCD14[OR=19.033,95%CI:14.132-25.633]、RBP[OR=19.391,95%CI:12.783-29.415]、IL-27[OR=20.286,95%CI:15.067-27.312]水平均为硕通镜联合SMP术后尿源性脓毒血症的独立影响因素(P<0.05)。结论:硕通镜联合SMP术患者术后sCD14、RBP、IL-27水平明显升高,与尿源性脓毒血症有关,检测其水平有助于早期诊断。

Objective:To explore the relationship between the levels of soluble leukocyte differentiation antigen 14(sCD14),retinol binding protein(RBP),interleukin-27(IL-27)and urosepsis in patients underwent Shuotong mirror combined with super-minipercutaneous nephrolithotomy(SMP).Methods:102 patients underwent Shuotongmirror combined with SMP in our hospital from May 2015 to June 2021were retrospectively analyzed,including 51 patients with urosepsis(observation group)and 51 patients without urosepsis(control group).The clinical data,levels of sCD14,RBP and IL-27 before and after surgery were compared between the two groups,and received operating characteristic curve(ROC)was used to evaluate the diagnostic value of postoperative levelsof sCD14,RBP and IL-27 on urosepsis.Result:Compared with control group,the observation group had higher sCD14[(537.89±150.69)pg/ml vs.(354.89±112.41)pg/ml],RBP[(65.42±8.40)ng/L vs.(44.29±5.27)ng/L]and IL-27[(3.32±0.78)vs.(2.37±0.69)ng/ml],the difference was statistically significant(P<0.05).ROC curve showed that the AUCof sCD14,RBP and IL-27 in the diagnosis of urosepsiswere 0.828,0.901 and 0.857,respectively.Multivariate logistic regression analysis showed that postoperativelevels of sCD14[OR=19.033,95%CI:14.132-25.633],RBP[OR=19.391,95%CI:12.783-29.415],IL-27[OR=20.286,95%CI:15.067-27.312]were independent influencing factors for urosepsis after Suotong mirror combined with SMP(P<0.05).Conclusion:The levels of sCD14,RBP and IL-27 in patients undergoing Shuotong lens combined with SMP were significantly increased after operation,which was related to urosepsis,indicating that monitoring their levels may aid in early diagnosis.