尿白细胞计数与血C-反应蛋白水平对碎石术后感染风险的评估

Urine white blood cell counts and level of serum C-reactive protein for assessment of risk of infections after lithotrity

目的探讨尿白细胞计数及血C-反应蛋白(CRP)水平在经尿道输尿管境下碎石术术后感染风险中的评估,以降低术后感染的发生。方法选择住院的经尿道输尿管镜下碎石术治疗患者共720例,其术前24h内均进行了尿白细胞计数及血CRP检测,根据尿白细胞计数10/HP、血CRP 8 mg/L为界,比较术后感染发生率。结果 720例患者术前尿白细胞计数阳性174例、血CRP阳性201例,术后发生感染共99例,术前CRP阳性患者术后发生感染率为28.86%,显著高于CRP阴性患者的5.97%(χ2=53.651,P<0.001);尿白细胞计数与血CRP均阳性患者术后感染占35.71%,与尿白细胞计数阴性血CRP阳性患者的26.21%相比,差异无统计学意义;尿白细胞计数与血CRP阳性患者术后感染显著高于尿白细胞计数阳性血CRP阴性及尿白细胞计数阴性血CRP阴性患者,差异有统计学意义(P<0.01)。结论术前CRP水平>8mg/L是术后感染的重要危险因素,可以作为判断患者是否进行输尿管镜下碎石手术的一个指标,相比于尿白细胞计数,血CRP的预测价值更具重要。

OBJECTIVE To explore the urine white blood cell counts and level of serum C-reactive protein （CRP） for assessment of infections after the transurethral lithotripsy under ureteroscope so as to reduce the incidence of the postoperative infections .METHODS A total of 720 hospitalized patients who underwent the transurethral litho -tripsy under ureteroscope were enrolled in the study ,the urine white blood cell counts and the level of serum CRP were determined within 24 hours before the surgery ,then the 10/HP of urine white blood cell counts and 8 mg/L of serum CRP were defined as the boundary ,the incidence of the postoperative infections was compared .RESULTS Of the 720 patients ,174 were tested positive for the white blood cell counts before the surgery ,and 201 were test-ed positive for the serum CRP .Totally 99 cases had the postoperative infections ,the incidence of the postoperative infections was 28 .86% in the patients tested positive for CRP before the surgery ,significantly higher than 5 .97%in the patients tested negative for CRP （χ2 = 53 .651 ,P〈 0 .001） .The patients with postoperative infections tested positive for both the urine white blood cell counts and serum CRP accounted for 35 .71% ,as compared with 26 .21% of the patients tested negative for the white blood cell counts and positive for serum CRP ,there was no statistically significant difference .The incidence of the postoperative infections was significantly higher in the pa-tients tested positive for both urine white blood cell counts and CRP than in the patients tested positive for urine white blood cell counts and negative for serum CRP and than the patients tested negative for both urine white blood cell counts and serum CRP （P〈 0 .01） .CONCLUSION The level of preoperative CRP more than 8 mg/L is the ma-jor risk factor for the postoperative infection and can be used as an indicator for the conduct of the transurethral lithotripsy under ureteroscope ,as compared with the urine white blood cell counts ,the serum CRP has more significant prediction value .