尿WBC与CRP检测对输尿管结石患者术后感染的预测价值

Pre-operative Detection of WBC and CRP on the Prediction of Infection for the Patients with Post-transurethral Lithotripsy

目的:探讨术前尿白细胞计数(WBC)及C反应蛋白(CRP)水平检测对输尿管碎石术患者术后感染的预测价值。方法:选择2012年6月至2014年6月在我院接受输尿管镜下碎石术的200例患者的临床资料,术前24 h进行尿常规及CRP检测。根据尿WBC计数和CRP水平,将所选患者分为WBC阳性组、WBC阴性组、CRP阳性组、CRP阴性组、WBC阳性CRP阳性组、WBC阳性CRP阴性组、WBC阴性CRP阳性组以及WBC阴性CRP阴性组。比较各组患者术后感染的发生率。结果:WBC阳性组患者感染率为64.89%,WBC阴性组为56.31%,两组无显著差别(P>0.25)。CRP阳性组患者感染率为74.79%,CRP阴性组为45.68%,CRP阳性组高于阴性组,差异具有统计学意义(P<0.001)。WBC阳性CRP阳性组患者感染率为37.71%,WBC阳性CRP阴性组为10.43%,WBC阴性CRP阳性组为29.86%,WBC阴性CRP阴性组为5.93%。WBC阳性CRP阳性组患者感染率明显高于WBC阳性CRP阴性组及WBC阴性CRP阴性组,差异具有统计学意义(P<0.001)。WBC阳性CRP阳性组与WBC阴性CRP阳性组比较无显著差别(P>0.05)。结论:术前CRP水平>8 mg/L是术后发生感染的危险因素,可作为临床判断的一项预测指标。

Objective： To explore and evaluate pre-operative urine white cell and C-reactive protein in the applied value of the risk of infection post-transurethral lithotripsy. Methods： 200 patients who had taken the ureteroscopy lithotripsy in our hospital from June2012 to June 2014 wew selected and the clinical data of the patients were analyzed retrospectively. The preoperative 24 h urine routine and CRP of all the patients were detected. According to the urine WBC count and CRP levels, the selected patients were divided into the WBC positive group, the WBC negative group, the CRP positive group, the CRP negative group, the WBC positive and CRP positive group, the WBC positive and CRP negative group, the WBC negative and CRP positive group and the WBC negative and CRP negative group. Then the incidence of postoperative infection.were compred in the eight groups. Results： The WBC positive group was 64.89%,the WBC negative group was 56.31%, and there was no significant difference（P0.25）. Infection rate in CRP positive group was74.79%, which was higher than 45.68% in CRP negative group with statistically significant difference（P0.001）. The WBC infection rate was 37.71% in CRP positive group, 10.43% in the WBC positive and CRP negative group, 29.86% in the WBC negative and CRP positive group, and 5.93% in the WBC negative and CRP negative group. The WBC positive rate in CRP positive group was obviously higher than that of the WBC positive and CRP negative group with statistically significant difference（P0.001）. There was no statistically significant difference between the WBC positive and CRP positive group and the WBC negative and CRP positive group（P0.05）.Conclusions： Preoperative CRP level8 mg/l was an important predictor of postoperative infection after transurethral lithotripsy. It can be used as the indicator to determine whether the patients were ureteroscopic lithotripsy. The CRP level has more predictive value comparing to the urine WBC.