超敏C反应蛋白与白蛋白比值对经皮肾镜手术后全身炎症反应的预测作用探讨

Predictive value of ratio of C-reactive protein and albumin in systematic inflammatory reaction after percutaneous nephrolithotomy

目的:探讨超敏C反应蛋白与白蛋白比值(hs-CRP/Alb)对经皮肾镜手术(PCNL)后全身炎症反应(SIRS)的预测作用。方法:选取2014年1月-2018年3月接受PCNL治疗的患者119例。根据患者术后是否出现SIRS将患者分为SIRS组28例,非SIRS组91例。收集两组患者术前、术后的临床基本资料,全身炎症指标等进行比较。采用受试者工作特征(ROC)曲线分析,评估hs-CRP/Alb比值对PCNL术后SIRS发生的预测作用。结果:SIRS组患者的hs-CRP、白细胞计数、中性粒细胞计数、单核细胞计数、hs-CRP/Alb、NLR、PLR均显著高于非SIRS组(P<0.05);但SIRS组患者的淋巴细胞计数、血红蛋白、LMR和PNI均显著低于非SIRS组(P<0.05);两组患者的血小板计数比较差异无统计学意义(P>0.05)。根据ROC曲线分析可知,hs-CRP/Alb比值预测PCNL术后发生SIRS的最佳阈值为0.102,其特异性为0.755,敏感性为0.948,曲线下面积为0.934。结论:hs-CRP/Alb对PCNL术后SIRS有很好的预测作用,具有重要的临床意义。

Objective:To explore the predictive value of the ratio of C-reactive protein(CRP)and albumin(Alb)in systematic inflammatory reaction syndrome(SIRS)after percutaneous nephrolithotomy(PCNL).Methods:A total of 119 patients undergoing PCNL in our hospital from January 2014 to March 2018 were enrolled in this study.Based on whether having SIRS after operation,they were divided into two groups:SIRS group(n=28)and non-SIRS group(n=91).Clinical characteristics before and after operation,and systematic inflammatory indexes were collected and compared between two groups.Receiver operation characteristics curve(ROC)analysis was employed to study the predictive value of the hs-CRP/Alb ratio in SIRS after PCNL.Results:Patients in SIRS group showed significantly higher level of hs-CRP,white blood cell count,neutrophil count,mononuclear cell count,hs-CRP/Alb ratio,NLR and PLR than those in non-SIRS group(P<0.05).However,the levels of lymphocyte count,hemoglobin,LMR and PNI in SIRS group was significantly lower than those in non-SIRS group(P<0.05).There was no significant difference in platelet count between two groups(P>0.05).The ROC analysis revealed the optimal cut-off value of the hs-CRP/Alb ratio was 0.102 with the specificity of 0.755,the sensitivity of 0.948 and the area under curve of 0.934.Conclusion:The hs-CRP/Alb ratio had a nice performance in predicting SIRS after PCNL,which was worthy promoting clinically.