尿肝素结合蛋白对上尿路复杂性结石合并感染的诊断价值

Diagnostic value of urine heparin-binding protein in upper urinary tract complicated stones with infection

目的探究尿液中肝素结合蛋白对上尿路复杂性结石合并感染的诊断价值,指导临床抗生素的使用,预防经皮肾镜碎石取石术后脓毒性休克的发生。方法回顾性研究2017年5月至2019年1月就诊于本中心的134例上尿路复杂性结石且行经皮肾镜碎石取石术患者的临床资料,术前均留取尿标本检测肝素结合蛋白,分析术前肝素结合蛋白水平与感染性结石之间的关系。结果134例患者术中发现感染性结石的有64例,术前尿液检测肝素结合蛋白异常的有69例,敏感性为96.88%(62/64),特异性为90.00%(63/70),阳性预测值为89.86%(62/69),阴性预测值为96.92%(63/65);x^2=101.02, P=0.001,差异有统计学意义。3例肝素结合蛋白水平较高的患者术后发生脓毒性休克。结论尿肝素结合蛋白预测上尿路感染性结石具有较好的真实性,可用于指导术前抗生素的应用,预防或减少经皮肾镜术后脓毒性休克的发生。

Objective To explore the diagnostic value of heparin-binding protein in urine for upper urinary tract complicated stones complicated with infection, guide the use of clinical antibiotics, and prevent the occurrence of septic shock after percutaneous nephrolithotomy. Methods A retrospective analysis was performed on 134 patients with upper urinary tract complicated stones admitted to our center from May 2017 to January 2019 who underwent percutaneous nephrolithotomy. Urine specimens were taken before the operation to examine heparin-binding protein, and the relationship between the preoperative level of heparin -binding protein and infectious stones was analyzed. Results 64 of 134 patients were found to have infectious stones during surgery, and 69 of them were found to have abnormal heparin-binding protein in preoperative urine test. The sensitivity was 96. 88%(62/64), the specificity was 90. 00%( 63/70 ), the positive predictive value was 89. 86%( 62/69), and the negative predictive value was 96. 92%(63/65 ), x2 = 101.02, P = 0.001, the difference was statistically significant. Septic shock occurred in 3 patients with higher heparin binding protein levels after surgery. Conclusions Heparin-binding protein in urine can better predict upper urinary tract infectious stones, guide the application of preoperative antibiotics, and pre丒 vent or reduce the occurrence of septic shock after percutaneous nephrolithotomy.