血清内毒素、hs-CRP与肝素结合蛋白检测在肾结石炎症反应早期诊断中的应用价值

Application value of combined detection of serum endotoxin,hs-CRP and heparin-binding protein in the early diagnostic process of inflammatory response to renal calculi

目的探讨血清内毒素、血清高敏C-反应蛋白(hs-CKP)与肝素结合蛋白(HBP)检测在肾结石炎症反应早期诊断中的应用价值。方法选取本院2016年5月至2018年5月期间收治的经皮肾镜取石术治疗的180例患者作为研究对象,分为炎症反应组(80例)与非炎症反应组(100例),同时纳人同期健康体检人群作为对照组,对上述三组人群的血清指标进行比较分析:结果治疗前,三组患者的血清内毒素、hs-CRP、HBP水平组间比较,差异均有统计学意义(P<0.05)。炎症反应组治疗后的各指标水平显著低于治疗前(t=12.044、17.914、19.013,P<0.001)。三者联合检测时,其灵敏度、特异度、准确度均显著高于单独检测任一血清学指标(P<0.05),联合检测的R0C曲线面积最大(0.896),其灵敏度为92.67%,特异度为94.09%,准确度为91.57%。结论血清内毒素、hs-CRP与HBP水平联合检测能有效提高肾结石炎症反应监测的准确度、灵敏度及特异度,值得临床推广。

Objective To investigate the application value of serum endotoxin,serum high-sensitivity C-reactive protein(hs-CRP)and heparin-binding protein(HBP)in the early diagnosis of renal stone inflammation.Methods One hundred and eighty patients treated with percutaneous nephrolithotomy admitted to our hospital from May 2016 to May 2018 were selected as the research subjects,and divided into the inflammatory response group(80 cases)and the non-inflammatory response group(100 cases).Meanwhile,healthy people who underwent physical examination during the same period were included as the control group.The serum indexes of the above three groups were compared and analyzed.Results Before treatment,there were statistically significant differences in serum endotoxin,hs-CRP and HBP levels among the three groups(P<0.05).The levels of all indexes in the inflammatory group after treatment were significantly lower than those before treatment(t=12.044,17.914,19.013,P<0.001).The sensitivity,specificity and accuracy of the combined detection of the three were significantly higher than those of any single serological index(P<0.05),and the ROC curve area of the combined detection was the largest(0.896),with a sensitivity of 92.67%,a specificity of 94.09%and an accuracy of 91.57%.Conclusions The combined detection of endotoxin,hs-CRP and HBP levels can effectively improve the accuracy,sensitivity and specificity of monitoring the inflammatory response of kidney stones,which is worthy of clinical promotion.